Avaliação do preparo para enterografia por tomografia computadorizada em pacientes com doença de Crohn
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Data
2017-02-24
Autores
Renosto, Fernanda Lofiego [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Doença de Crohn (DC) é uma doença inflamatória crônica, transmural, persistente ou recidivante. Localiza-se, principalmente na porção distal do intestino delgado (íleo) e proximal do cólon (ceco), entretanto pode acometer qualquer segmento do trato gastrintestinal. A Enterotomografia (Entero-TC) é uma técnica de alta resolução espacial que permite avaliar cada segmento intestinal sem sobreposição de alças e avalia, principalmente, a atividade da doença. Objetivo: Comparar a qualidade e aceitação de dois preparos orais em Entero-Tc nos pacientes com Doença de Crohn. Métodos: Trata-se de um estudo transversal. Os pacientes foram randomizados em dois grupos. Preparo A: 78,75g de Polietilenoglicol em 1000mL de água. Preparo B: 78,75g de Polietilenoglicol em 2000mL de água. Os preparos foram administrados via oral em um tempo de 45min a intervalos regulares de 15 minutos. Posteriormente, os pacientes foram submetidos ao exame Entero-Tc. Foi aplicado questionário de aceitação e tolerância do preparo após exame. Os itens avaliados foram facilidade de ingestão, sabor, presença de efeito colateral e se o paciente repetiria o exame. A qualidade do exame foi avaliada pelo radiologista, por meio do preenchimento dos segmentos intestinais e distensão luminal. Análise Estatística: descritiva, testes de associação (p<0,05). Resultados: Foram avaliados 58 pacientes (29 em cada grupo) nos quais: 58,62% mulheres, 34,49% em atividade clínica, 63,76% estavam em tratamento com biológicos, pela Escala Montreal: 63,79% A2 (idade de diagnóstico 17 a 40 anos), 60,34% L3 (localização ileocolônica), 53,43% B2 (comportamento estenosante). Com relação à qualidade entre os preparos, os segmentos jejuno, íleo, cólon ascendente, transverso, descendente e retossigmóide não apresentaram diferença no preenchimento, assim como a distensão luminal. Na avaliação da aceitação e tolerância, os pacientes do preparo B apresentaram mais efeitos colaterais e maior dificuldade para ingerir o preparo quando comparados com o preparo A, entretanto não foi estatisticamente significativo (p<0,06 para ambos). Conclusões: Não houve diferença na qualidade dos preparos no preenchimento e distensão luminal nos diferentes volumes de preparo. Com relação a aceitação e tolerância, o preparo de maior volume apresentou maiores efeitos colaterais e dificuldade de ingestão. Desta forma, concluímos ser possível a utilização de volumes menores de preparo, sem perda da qualidade da imagem e sendo o preparo mais tolerável pelos pacientes.
Introduction: Crohn's disease (CD) is a chronic, transmural inflammatory disease, persistent or relapsing. It is located mainly in the distal portion of the small intestine (ileum) and proximal colon (cecum), however can affect any segment of the gastrointestinal tract. The Enterography Tomography Computed (Entero-CT) is a technique of high spatial resolution that enables you to evaluate each intestinal segment without overlapping straps and evaluates the activity of the disease. Objective: To compare the quality and acceptance of two oral preparations in Entero-CT in patients with Crohn's disease. Methods: A cross-sectional study. Patients were randomized into two groups. Preparation A: 78, 75 g of polyethylene glycol in 1000 ml of water. Preparation B: 78, 75 g of polyethylene glycol in 2000 ml of water. Preparations were administered orally and administered in a time of 45 minutes at regular intervals of 15 minutes. Subsequently, the patients were subjected to Entero-CT examination. Questionnaire was applied for acceptance and tolerance of examination preparation. The items evaluated were ease of ingestion, flavor, the presence of side effect and if the patient repeat the exam. The quality of review was evaluated by the radiologist, through completion of intestinal segments and luminal distension. Statistical analysis: descriptive, membership testing (p < 0.05). Results: 58 patients were evaluated (29 in each group) in which: 58.62% women, 34.49% in clinical activity, 63.76% were in biological treatment, by Montreal: 63.79% A2 (age 17 to 40 years diagnostic), 60.34% L3 (ileocolonic location), 53.43% B2 (stenosing behavior). With regard to the quality between preparations, the jejunum, ileum, ascending colon, transverse, descending and retossigmoid showed no difference in filling, as well as the luminal distension. In the evaluation of acceptance and tolerance, staging B patients showed more side effects and greater difficulty to ingest the preparation when compared with the preparation, however was not statistically significant (p < 0.06 for both). Conclusions: There was no difference in the quality of the preparations in the filling and distension luminal in different staging volumes. With respect to acceptance and tolerance, the preparation of higher volume presented greater side effects and difficulty swallowing. Thus, we conclude that it is possible to use smaller volumes of preparation, without loss of image quality and being the preparation more tolerable for patients.
Introduction: Crohn's disease (CD) is a chronic, transmural inflammatory disease, persistent or relapsing. It is located mainly in the distal portion of the small intestine (ileum) and proximal colon (cecum), however can affect any segment of the gastrointestinal tract. The Enterography Tomography Computed (Entero-CT) is a technique of high spatial resolution that enables you to evaluate each intestinal segment without overlapping straps and evaluates the activity of the disease. Objective: To compare the quality and acceptance of two oral preparations in Entero-CT in patients with Crohn's disease. Methods: A cross-sectional study. Patients were randomized into two groups. Preparation A: 78, 75 g of polyethylene glycol in 1000 ml of water. Preparation B: 78, 75 g of polyethylene glycol in 2000 ml of water. Preparations were administered orally and administered in a time of 45 minutes at regular intervals of 15 minutes. Subsequently, the patients were subjected to Entero-CT examination. Questionnaire was applied for acceptance and tolerance of examination preparation. The items evaluated were ease of ingestion, flavor, the presence of side effect and if the patient repeat the exam. The quality of review was evaluated by the radiologist, through completion of intestinal segments and luminal distension. Statistical analysis: descriptive, membership testing (p < 0.05). Results: 58 patients were evaluated (29 in each group) in which: 58.62% women, 34.49% in clinical activity, 63.76% were in biological treatment, by Montreal: 63.79% A2 (age 17 to 40 years diagnostic), 60.34% L3 (ileocolonic location), 53.43% B2 (stenosing behavior). With regard to the quality between preparations, the jejunum, ileum, ascending colon, transverse, descending and retossigmoid showed no difference in filling, as well as the luminal distension. In the evaluation of acceptance and tolerance, staging B patients showed more side effects and greater difficulty to ingest the preparation when compared with the preparation, however was not statistically significant (p < 0.06 for both). Conclusions: There was no difference in the quality of the preparations in the filling and distension luminal in different staging volumes. With respect to acceptance and tolerance, the preparation of higher volume presented greater side effects and difficulty swallowing. Thus, we conclude that it is possible to use smaller volumes of preparation, without loss of image quality and being the preparation more tolerable for patients.
Descrição
Palavras-chave
Doença de Crohn, Enterografia por tomografia computadorizada, Polietilenoglicol, Crohn's disease, Enterography tomography computed, Polyethylene glycol