캡슐내시경 검사의 전처치로 Sodium Phosphate의 경구 투여 효과 = Efficacy of Oral Sodium Phosphate Preparation for Capsule Endoscopy

국문 초록 (Abstract)

목적: 소장질환의 진단에 매우 유용한 검사로 인정받고 있는 캡슐내시경 검사는 전처치에 대한 표준화된 기준이 없는 실정으로 현재 각 병원에서 각기 다른 전처치를 하고 있다. 이에 저자들은 캡슐내시경 검사의 전처치에 따른 영상 판독의 적절성에 대해 평가하고자 하였다. 대상 및 방법: 2003년 3월부터 2004년 9월까지 본원에서 캡슐내시경 검사를 시행한 환자 중 전처치로 sennosides를 사용한 군 88명과 sodium phosphate를 사용한 군 41명을 대상으로 영상의 적절성을 후향적으로 비교하였다. Sennosides군은 전날 저녁 10시에 sennosides 8 g과 물 1 L, 검사 당일 아침 5시에 sennosides 8 g과 물 1 L를 마시게 하였으며 sodium phosphate군은 전날 저녁 8시에 sodium phosphate 45 mL와 물 45 mL를 함께 투여 후 물 2 L를 마시게 하였으며 당일 아침 5시에 sodium phosphate 45 mL와 물 45 mL 투여 후 물 1 L를 마시게 하였다. 이들의 판독은 RAPID 워크스테이션 영상 시스템을 통해 음식물, 기포, 점액, 그리고 담즙 등 판독장애 요인이 소장 점막 25% 미만을 차지하는 경우를 청결한 영상으로, 25% 이상인 경우를 판독에 부적절한 영상으로 정의하였다. 전체 소장 통과 시간에 대한 부적절한 영상의 시간 비를 객관적 수치로 평가하였으며 객관적 수치가 10% 미만인 경우를 적절한 전처치로 평가하였다. 결과: 적절한 전처치를 보이는 경우가 sennosides군에서 35예(35/88, 40%), sodium phosphate군에서 26예(26/41, 63%)였으며 sodium phosphate군에서 통계학적으로 유의한 좋은 영상을 보였다(p＜0.05). 결론: 캡슐내시경 검사의 전처치로 sodium phosphate의 전처치가 sennosides를 전처치로 사용한 경우보다 더 좋은 영상을 얻을 수 있었다.

다국어 초록 (Multilingual Abstract)

Background/Aims: Capsule endoscopy is an effective diagnostic tool for detecting small bowel disease. However, the method of bowel preparation for capsule endoscopy has not been standardized. The aim of this study was to evaluate the efficacy of oral sodium phosphate as a preparation for capsule endoscopy. Methods: A total of 129 cases who underwent capsule endoscopy from Mar. 2003 to Sep. 2004 were analyzed retrospectively. Eighty- eight cases were prepared with sennosides (Alaxyl ) and 41 cases were prepared with sodium phosphate. The intestinal mucosa was defined as being unclean if the intestinal content, food materials, and bubbles covered more than 25% of the mucosal surface. Using a stopwatch, the exact time of the unclean image was recorded. The percentage of the unclean image for the small intestinal transit time (SITT) was calculated as an objective score. Small bowel cleansing was considered 'adequate' if the objective score was ＜10% and 'inadequate' if the objective score was 10% or greater. Results: 35 cases (40%) showed an adequate image in the sennosides and simethicone group and 26 cases (63%) showed an adequate image in the sodium phosphate and simethicone group. The adequacy rate was significantly higher in the sodium phosphate group than in the sennosides group (p＜0.05). Conclusions: Capsule endoscopy prepared by sodium phosphate and simethicone produced a better visual image than sennosides and simethicone. (Korean J Gastrointest Endosc 2006;32:173-178)

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