Abstract: Objective    To compare the efficacy of different doses of simethicone on operation of upper endoscopy for children. Methods    Patients aged ≥2 years old who received upper endoscopy in Children’s Hospital of Chongqing Medical University from Mar.1 to Dec.31 of 2022 were included in this study. Study subjects were randomly assigned to 4 groups. Group A received 20 mL water before examination as control， Group B received 40 mg simethicone， Group C received 100 mg simethicone， and Group D received 200 mg simethicone. Visibility of upper endoscopy， procedure time， cases requiring endoscopic flushing， and cases of oxygen desaturation were compared and analyzed. Results    A total of 800 pediatric patients were included in this study， 200 patients in each group. There were no significant differences regarding gender composition and mean age in each group（χ2=0.981， H=2.239， P>0.05）. The proportion of adequate visibility in Group A， Group B， Group C and Group D was 38.5%、66%、80.5% and 78.5%， respectively. The proportion of adequate visibility in group A was significantly lower than that in the other groups（χ2AB=30.331，χ2AC=73.203，χ2AD=65.905， all P<0.05）. The proportion of adequate visibility in Group B was significantly lower than that in Group C and Group D（χ2BC=10.730， χ2BD=7.793， all P<0.05）. No significant differences were detected regarding proportion of adequate visibility between Group C and Group D（P>0.05）. Procedure time in group B ［（192.0±53.6）s］， group C ［（169.0±45.8）s］， and group D ［（169.8±46.6）s］ was significant shorter than that in group A ［（221.2±58.8）］（ZAB=-4.412，ZAC=-8.373，ZAD=-8.023，all P<0.05）. Procedure time in Group C and Group D was significant shorter than that in Group B（ZBC=-4.5， ZBD=-4.418， all P <0.05）. No significant differences were detected regarding procedure time between Group C and Group D（P>0.05）. Cases requiring endoscopic flushing in Group A （76 cases） were significantly higher than those in Group B （24 cases）， Group C（10 cases）， and Group D （11 cases）（χ2 AB=36.053， χ2AC=63.394， χ2AD=62.062， all P<0.05）. Cases requiring endoscopic flushing in Group B were significantly higher than those in Group C and Group D（χ2BC=6.076， χ2BD=5.292， all P<0.05）. No significant differences were detected regarding cases requiring endoscopic flushing between Group C and Group D（P>0.05）. There were no significant differences regarding cases of oxygen desaturation among the 4 groups（P>0.05）. Conclusion    Premedication of simethicone can significantly improve the visibility during upper endoscopy in children，and 100 mg simethicone is enough to achieve an ideal cleaning effect.

Key words: simethicone, upper endoscopy, visibility, child

摘要： 目的    探讨不同剂量西甲硅油对儿童胃镜操作的影响。方法    以重庆医科大学附属儿童医院预约行胃镜检查的≥2岁儿童作为研究对象。采用随机数字表法对2022-03-01—2022-12-31预约行胃镜检查的患儿随机分4组：A组口服20 mL温水作为对照，B组口服40 mg西甲硅油，C组口服100 mg西甲硅油，D组口服200 mg西甲硅油。比较4组有效性指标（胃镜视野清晰度情况、胃镜操作时间、镜下冲洗例数）及安全性指标（氧饱和度下降例数）。结果    共纳入患儿800例，每组200例，各组性别构成和年龄分布差异无统计学意义（χ2=0.981、H=2.239，均P>0.05）。视野清晰度良好率：A组、B组、C组和D组分别为38.5%、66%、80.5%和78.5%，A组低于B组、C组及D组（χ2 AB=30.331、χ2 AC=73.203、χ2 AD=65.905，均P<0.05）；B组低于C组和D组（χ2 BC =10.730、χ2 BD =7.793，均P<0.05）；C组与D组差异无统计学意义（P>0.05）。胃镜操作时间：B组（192.0±53.6）s、C组（169.0±45.8）s及D组（169.8±46.6）s显著短于A组（221.2±58.8）s（Z AB=-4.412、Z AC=-8.373、Z AD=-8.023，均P<0.05）；C组和D组短于B组（Z BC=-4.5、Z BD=-4.418，均P<0.05）；C组与D组差异无统计学意义（P>0.05）。镜下冲洗例数：A组（76例）显著高于B组（24例）、C组（10例）及D组（11例，χ2 AB=36.053、χ2 AC=63.394、χ2 AD=62.062，均P<0.05）；B组高于C组和D组（χ2 BC=6.076、χ2 BD=5.292，均P<0.05）；C组与D组差异无统计学意义（P>0.05）。氧饱和度下降例数：4组比较差异无统计学意义（P>0.05）。结论    儿童胃镜检查前口服西甲硅油可显著提升胃镜视野清晰度，100 mg西甲硅油即可达到理想的清洁效果。

关键词: 西甲硅油, 胃镜检查, 视野清晰度, 儿童