达克罗宁胶浆不同给药时间对普通肠镜检查效果的影响

Influence of different administration timing of dyclonine hydrochloride mucilage on the efficacy of conventional colonoscopy

摘要:

目的 探讨达克罗宁胶浆不同给药时间对普通肠镜检查效果的影响。方法 选取2023年12月－2024年11月于该院内镜中心接受普通肠镜检查的患者120例，根据达克罗宁胶浆不同给药时间，分为：A组、B组和C组，每组40例。A组肠道准备完成30 min后口服盐酸达克罗宁胶浆，B组退镜过程中喷洒盐酸达克罗宁胶浆溶液，C组退镜过程中用生理盐水冲洗。比较3组血流动力学指标［收缩压、舒张压和心率（HR）］、祛泡效果、肠道清洁度［波士顿肠道准备评分量表（BBPS）］、认知功能［Trieger点测试和数字符号试验（DST）］、术后腹胀情况和不良反应。结果 检查5 min时，A组收缩压、舒张压和HR低于B组和C组，A组和B组祛泡等级Ⅰ级占比高于C组，差异均有统计学意义（P < 0.05）；检查后10 min，A组收缩压、舒张压和HR仍低于B组和C组，差异均有统计学意义（P < 0.05）；检查后30 min，A组Trieger点测试错误点数多于B组和C组，且DST 90 s正确数少于B组和C组，差异均有统计学意义（P < 0.05）；A组和B组术后肠道功能恢复优良率高于C组，差异均有统计学意义（P < 0.05）；3组BBPS比较，差异无统计学意义（P > 0.05）；肠镜检查过程中，3组均未发生明显不良反应。结论 普通肠镜检查中应用达克罗宁胶浆，可改善患者检查期间循环稳定性，提高肠道祛泡效果，促进术后胃肠功能恢复。检查前口服给药可维持患者血流动力学稳定。相较于口服给药，退镜时喷洒达克罗宁对患者术后早期认知功能影响较小。临床可根据患者具体情况，个体化选择给药时机，以提高肠镜检查的安全性与舒适性。

Abstract:

Objective To explore the effects of different administration timing of dyclonine hydrochloride mucilage on the efficacy of conventional colonoscopy.Methods 120 patients who underwent conventional colonoscopy at the endoscopy center of our hospital from December 2023 to November 2024 were enrolled. According to different administration times of dyclonine hydrochloride mucilage, patients were divided into group A, group B and group C, with 40 cases in each group. Group A was given oral dyclonine hydrochloride mucilage 30 min after bowel preparation. Group B was sprayed with dyclonine hydrochloride mucilage solution during colonoscope withdrawal, while group C was irrigated with normal saline during withdrawal. Hemodynamic parameters [systolic blood pressure, diastolic blood pressure, heart rate (HR)], defoaming efficacy, intestinal cleanliness [Boston bowel preparation scale (BBPS)], cognitive function [Trieger dot test and digit symbol test (DST)], postoperative abdominal distension, and adverse reactions were compared among the three groups.Results At 5 minutes during examination, systolic blood pressure, diastolic blood pressure and HR in group A were significantly lower than those in group B and group C. The rate of grade-Ⅰ defoaming effect in group A and group B was higher than that in group C, with statistically significant differences (P < 0.05). Ten minutes after the examination, systolic blood pressure, diastolic blood pressure, and HR in group A were still lower than those in group B and group C, and the differences were statistically significant (P < 0.05). At 30 min after the examination, the number of wrong dots in the Trieger dot test of group A was more than that of group B and group C, and the number of correct items in the 90-second DST was less than that of group B and group C, and the differences were statistically significant (P < 0.05). The excellent-good recovery rate of postoperative intestinal function in group A and group B was higher than that in group C, and the differences were statistically significant (P < 0.05). There was no statistically significant difference in BBPS scores among the three groups (P > 0.05). No obvious adverse reactions occurred in the three groups during colonoscopy.Conclusion The application of dyclonine hydrochloride mucilage during conventional colonoscopy can improve patients’ hemodynamic stability, enhance the intestinal defoaming effect and promote the recovery of postoperative gastrointestinal function. Oral administration before examination can maintain stable hemodynamics. Compared with oral administration, spraying dyclonine during withdrawal exerts slight impacts on patients’ early postoperative cognitive function. Clinicians may select the administration timing individually according to patients’ specific conditions so as to improve the safety and comfort of colonoscopy.