结肠镜检查肠道准备改良方法探讨

Improving method of bowel preperation before colonscopy

目的探讨一种安全、有效的肠道准备方法,以增加肠镜检查的成功率与受检病人的依从性,减少并发症。方法随机将来院行肠镜检查的病人(n=200例)分成两组。A组传统方法组(n=100),术前半流或流质2、3d,检查当日禁食,当日晨口服20%甘露醇250mL。B组改良方法组(n=100),术前进普食,检查当日禁食,当日晨口服20%甘露醇250mL,并加服5%糖盐水,65岁以上老年人检查当日静脉输注等渗溶液1000mL。以上分组中,如遇习惯性便秘病人,均提前3d给予缓泻剂,以达到每天有稀糊状或软便为佳。结果B组肠道清洁率(91.8%)与A组(92.6%)相比,P>0.05,差异无显著性。到达回盲瓣成功率B组(n=97例,94.0%)与A组(n=94例,95.0%)相比P>0.05,差异无显著性。病人对肠道准备的可耐受程度B组(91.8%)明显高于A组(77.7%),P<0.01。并发症发生率B组(低血糖3例,肠梗阻1例,4.1%)明显低于A组(低血糖6例,低血容量性休克1例,脑梗死2例,9.4%),两组相比,P<0.01,差异有显著性。结论肠镜检查前采用改良方法准备肠道,同样能达到较满意的清洁效果,且并发症发生率低,病人依从性明显增加,不失为一种很好的肠道准备方法。

[Objective] To study an effective and safe method of bowel prepemtion before colonscopy. [Methotis] 191 patients preparing for colonscopy were randomly divided into two groups： traditional group （group A）, patient eats demi-flow diet or flow diet for 2-3 days before examination, and fasting on the day when examination then took 250 mL 20% Manicol liquid and 1 500-2 000 mL water. Improving group （group B）： patient eats common diet and fasting on the day when examination, then took 250 mL 20%Manicol liquid and 1 500-2 000 mL 5%GNS. The aged people above 65-years old should been infusion 1 000 mL 0.9%NS into vein above divided into groups, the patients having habitual constipation should be taken Laxness for 3 days before examination. [Results] Bowel cleaning rate in group B （91.8%） was good as group A （92.6%）, P 〉0.05. The rate of success to ileo-colon valve in group B （94%） was good as group A （95%）, P〉0.05. The degree of acceptable bowel preperation in group B （91.8%） was better than it in Group A （77.7%）, P 〈0.01. The rate of complication in group B （4.1%） was lower than it in group A （9.4%） P 〈0.01. [Conclusions] Improving method of bowel prepemtion before eolonseopy is a good one.