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黏液溶解剂在上消化道内镜检查中的价值研究

杜 明静, 陈小 华*

摘要

目的:探究黏液溶解剂(链酶蛋白酶与N-乙酰半胱氨酸)在上消化道内镜检查中的应用价值。方法:选取我院接受上消化道内镜检查的患者150例,随机分为3组,根据纳入、排除及脱落标准,最终入组146人,A组(二甲硅油组)49人,B组(二甲硅油+链酶蛋白酶组)49人,C组(二甲硅油+N-乙酰半胱氨酸组)48人。对比3组患者的粘膜清晰度评分、内镜操作时间、病理组织学与13C-尿素呼气实验(13C-Urea Breath Test,13C-UBT)检测幽门螺杆菌一致性以及不良反应。结果:A组食管、贲门、胃体、胃窦、胃底、胃角、幽门及总清晰度评分高于对B组、C组,差异有统计学意义(P<0.05),B组食管、贲门、胃体、胃窦、胃底、胃角、幽门及总清晰度评分与C组相近,差异无统计学意义(P>0.05);A组内镜操作时间长于B组、C组,差异有统计学意义(P<0.05),B组内镜操作时间与C组相近,差异无统计学意义(P>0.05);以13C-UBT为“金标准”,A组、B组、C组3组的内镜病理组织学与13C-UBT诊断HP一致性相当,差异无统计学意义(P>0.05);本研究中未记录到不良反应发生。结论:链酶蛋白酶与N-乙酰半胱氨酸在上消化道内镜检查中均能够提高粘膜清晰度,缩短内镜操作时间,二者在提高粘膜清晰度、缩短操作时间方面效果相当;应用链酶蛋白酶与N-乙酰半胱氨酸预处理不影响病理组织学诊断幽门螺杆菌,无不良反应发生。

关键词

粘膜清晰度;链酶蛋白酶;N-乙酰半胱氨酸;幽门螺杆菌

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参考

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