聚乙二醇电解质溶液分次与单次口服肠道准备方案的清洁效果和耐受性比较

摘要

Colonoscopy has been accepted as the standard method for evaluation of colon and rectum,its success rate depends on the quality of bowel preparation. Aims:To evaluate the cleanliness and tolerance of fractionated dose versus single dose polyethylene glycol electrolyte solution( PEG-ES) bowel preparation regimens for colonoscopy. Methods:A total of 427 consecutive asymptomatic individuals undergoing colorectal cancer screening were enrolled and randomly assigned into 2 groups. Subjects in group A drank 1. 5 L PEG-ES on the eve and 4 hours before colonoscopy, respectively;subjects in group B received a single dose of 3 L PEG-ES 5 hours before colonoscopy. Score and degree of Boston bowel preparation scale(BBPS)and PEG-ES related adverse effects of the two groups were assessed and compared. Results:There were no significant differences in gender,age and cecal insertion rate between group A and group B(P ﹥ 0. 05). Score of BBPS was significantly higher in group A than in group B(P ﹤0. 01). Both regimens met the requirement of conventional colonoscopy,however,the cleanliness of colon was graded as excellent in more subjects of group A( P ﹤ 0. 01),and less subjects of group A complained PEG-ES related nausea(P ﹤0. 05). Logistic regression analysis revealed that the PEG-ES drinking pattern was associated with cleanliness of colon and occurrence of nausea( P ﹤ 0. 05). Conclusions:Fractionated dose PEG-ES regimen provides a better colonic cleansing quality and tolerance for bowel preparation of colonoscopy,which is superior to that of single dose regimen.%背景：结肠镜检查是公认的结直肠检查的金标准，而良好的肠道准备是检查成功的前提条件。目的：评价聚乙二醇电解质溶液（ PEG-ES）分次与单次口服作为结肠镜检查肠道准备方案的清洁效果和耐受性。方法：连续纳入427例进行结直肠癌筛查的无症状个体，随机分为A组和B组。A组于检查前夜和检查前4 h分别口服1.5 L PEG-ES，B组于检查前5 h口服3 L PEG-ES，评估、比较两组Boston肠道准备量表（ BBPS）评分、等级和不良反应发生情况。结果：A组与B组间性别、年龄和盲肠插管率差异无统计学意义（ P﹥0.05）。A组BBPS评分显著高于B组（P﹤0.01）；尽管两种方案均能满足常规结肠镜检查的要求，但A组达到excellent肠道清洁等级者的比例显著高于B组（P﹤0.01），恶心症状发生率显著低于B组（P﹤0.05）。Logistic回归分析显示PEG-ES服用方式对肠道清洁度和恶心症状的发生有显著影响（ P﹤0.05）。结论：与单次口服相比，分次口服PEG-ES的结肠镜检查肠道准备方案能获得更满意的肠道清洁效果且耐受性良好。