乳果糖在老年患者结肠镜特殊治疗术前肠道准备中的应用效果研究

Application of Lactulose in Pre-operative Bowel Preparation in Elderly Patients Undergoing Special Colonoscopy Treatment

目的观察乳果糖在老年患者结肠镜特殊治疗术前肠道准备中的应用效果。方法选取2008年9月—2012年7月就诊于我院的需行结肠镜特殊治疗术的老年患者420例,采用随机数字表法将患者分为硫酸镁组140例,乳果糖组140例,乳果糖+硫酸镁组140例。硫酸镁组于术前6 h口服50%硫酸镁50 ml,服药后10 min内饮温开水500 ml,排便后1 h内再饮温开水2 000～2 500 ml,直至排出透明水样便;乳果糖组术前3～4 d依排便情况给予乳果糖10～30 ml口服,3次/d,术前6 h乳果糖200～300 ml口服,饮温开水2 000～3 000 ml;乳果糖+硫酸镁组术前3～4 d依排便情况给予乳果糖10～30 ml口服,3次/d,术前6 h口服50%硫酸镁50 ml。观察3组肠道准备满意率、患者耐受率、不良反应及并发症发生率。结果硫酸镁组肠道准备满意率为70.7%(99/140),乳果糖组为93.6%(131/140),乳果糖+硫酸镁组为90.0%(126/140),差异有统计学意义(χ2=32.8,P=0.000)。硫酸镁组患者耐受率为67.9%(95/140),乳果糖组为96.4%(135/140),乳果糖+硫酸镁组为75.7%(106/140),差异有统计学意义(χ2=38.1,P=0.000)。3组不良反应及并发症发生率比较,差异有统计学意义(χ2=19.9,P=0.000)。结论乳果糖应用于老年患者结肠镜特殊治疗术前肠道准备安全有效,患者耐受性好,易于接受,是一种较好的肠道准备方法。

Objective To observe the application of lactulose in pre-operative bowel preparation in elderly patients undergoing special colonoscopy treatment.Methods A total of 420 elderly patients admitted to our hospital between September 2008 and July 2012 needing special colonoscopy treatment were divided randomly into groups A,B,C,140 in each.Group A were given oral 50% magnesium sulfate(50 ml)6 h before operation,drank warm water(500 ml)10 min after drug administration,and more warm water(2 000~2 500 ml)1 h after defecation,until discharging transparent watery stools.Group B were given,according to defecation,oral lactulose(10~30 ml,3 times per day)3~4 d before operation,oral lactulose(200~300 ml)and warm water(2 000~3 000 ml)6 h before operation.Group C were given,according to defecation,oral lactulose(10~30 ml,3 times per day)3~4 d before operation,and then oral magnesium sulfate(50 ml)6 h before operation.The satisfaction rate of bowel preparation,patients′tolerance rate,incidence of adverse reactions and complications were observed.Results The satisfaction rate of bowel preparation was 70.7%(99/140)in group A,93.6%(131/140)in group B,90.0%(126/140)in group C,the difference was significant(χ2=32.8,P=0.000).The tolerance rate was 67.9%(95/140),96.4%(135/140),75.7%(106/140),respectively,the difference was significant(χ2=38.1,P=0.000).The incidence of adverse reactions and complications was significantly different(χ2=19.9,P=0.000).Conclusion Lactulose in preoperative preparation in elderly patients undergoing special colonoscopy treatment,safe,effective,well-tolerated and easy to be accepted,is a good method for bowel preparation.