确定小肠囊内镜的最佳肠道准备:一个元综述和雨元分析
Ian Io Lei1, Pablo Cortegoso Valdivia2, Noemi Gualandi3
1Institute of Precision Diagnostics & Translational Medicine, University Hospital of Coventry and Warwickshire, Clifford Bridge Rd, Coventry CV2 2DX, UK; Warwick Medical School, University of Warwick, Coventry, UK.
清洁性肠道制备,特别是用聚乙烯糖醇 (PEG),显著改善了小肠囊内镜 (SBCE) 的清洁和诊断产量,与单独禁食相比. 同一天的PEG方案是最有效的提高可视化和准确性.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 证据综合 证据综合
背景情况:
- 小肠囊内镜 (SBCE) 对于诊断胃肠道疾病至关重要.
- 对SBCE的最佳肠道准备仍在争论中,关于清洗与禁食协议的证据相互矛盾.
研究的目的:
- 综合高质量的证据,以确定SBCE最有效,安全和标准化的肠道制备方法.
- 为了比较净化方案与仅禁食的协议,关于清洁质量,诊断产量和完成率.
主要方法:
- 一个系统性审查的元综述和元分析,比较SBCE的净化与禁食准备.
- 包括10项系统性审查 (53项独特的初级研究,9,636名参与者);39项研究通过总体元分析进行了合成.
- 评估方法质量 (AMSTAR-2),审查间重叠 (CCA) 和证据确定性 (GRADE).
主要成果:
- 净化制剂显著改善了清洁的充分性 (RR=1.26) 与禁食相比,聚乙烯糖醇 (PEG) 显示出显著的影响.
- 同一天的PEG剂量证明了对清洁质量 (RR=1.75) 和诊断产量 (RR=1.30) 的最大益处.
- 净化剂在诊断产量 (RR=1.12) 和完成率 (RR=1.02) 中比禁食提供了边际收益.
结论:
- 清洗性肠道准备,特别是PEG,对于SBCE的适当清洁和诊断准确性来说,优于禁食.
- 与药剂剂量相比,在优化清洁和诊断产量方面,当天给药时间更为关键.
- 这一元分析为SBCE中标准化,有效的准备协议提供了证据.
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