摘要目的：探讨链霉蛋白酶联合西甲硅油作为胃镜检查术前准备用药的有效性。方法2014年1月至2014年11月，4690例常规胃镜检查（非无痛胃镜检查）患者，采用随机数字表法随机分成3组，链霉蛋白酶＋西甲硅油组1602例、西甲硅油组1548例、对照组1540例，分别口服不同的术前用药，对比分析各组术中胃镜视野清晰度分级结果。结果3组均完成所有胃镜检查，检查过程中均未发生严重不良反应。胃镜视野清晰度达到A级和B级的总例数，链霉蛋白酶＋西甲硅油组为1318例（82?3％），西甲硅油组为1048例（67?7％），对照组为432例（28?1％），链霉蛋白酶＋西甲硅油组胃镜视野清晰度明显优于西甲硅油组（χ2＝89?42，P＝0?000），而西甲硅油组又明显好于对照组（χ2＝486?30，P＝0?000）。结论胃镜检查术前口服链霉蛋白酶联合西甲硅油可以显著改善术中胃镜视野清晰度。

abstractsObjective To evaluate the efficacy of premedication of pronase and simethicone before upper gastrointestinal endoscopy. Methods A total of 4 690 patients undergoing upper gastrointestinal en?doscopy from January 2014 to November 2014 were recruited at gastrointestinal endoscopy center in Beijing Military General Hospital. All patients were randomized into 3 groups. The pronase plus simethicone group( n=1 602) took 40 ml mixed solution of pronase, sodium bicarbonate and simethicone orally 20 minutes before endoscopy. The simethicone group( n=1 548) took 40 ml simethicone orally 20 minutes before endoscopy. And the control group( n=1 540) took 10 ml lidocaine hydrochloride mucilage orally 5 minutes before endos?copy. The visibility during gastroscopy was observed. Results Each patient underwent gastroscopy, and no severe adverse event occurred during the procedure. The visibility of 82?3%( n=1 318) of the pronase plus simethicone group, 67?7%( n=1 048) of the simethicone group and 28?1% patients( n=432) of the control group respectively reached grade A or B. The visibility during gastroscopy in the pronase plus simethicone group was higher than that in the simethicone group(χ2=89?42, P=0?000) , while that in the simethicone group was higher than that of the control group(χ2=486?30, P=0?000). Conclusion Premedication of pronase and simethicone can improve the visibility during gastroscopy.