即时结肠灌注肠道清洁效果的临床评估

Evaluation of the Effect of a Colon Lavage Device and Oral Mannitol for Intestinal Cleansing in Patients before Colonoscopy

目的观察结肠灌注透析仪在结肠镜检查前肠道准备的清洁效果及其不良反应。方法200例接受肠镜检查者肠道清洁前随机分为口服甘露醇组(A组)、即时结肠灌注组(B组)及联合A、B方法组(C组)。据结肠镜检查中肠道清洁程度(I～Ⅲ级)和清洁范围(0～4度)评价肠道清洁效果。结果C组肠道清洁程度和清洁范围最理想(1级:P均<0.01;I级+Ⅱ级:P<0.05;失败率:P均<0.05。4度:全结肠清洁率为39.39%,P<0.01)。B组降结肠以下清洁率(62.86%)显著高于A组和C组(P<0.05和P<0.01)。此外,3组不良反应发生率差异无统计学意义(P>0.05)。结论即时结肠灌注法安全、便捷、不良作用轻微,清洁效果也令人满意,尤其适用于降结肠、乙状结肠及直肠检查,特别是镜下高频或微波治疗。结合口服泻剂则能满足全结肠甚至回肠下段检查和治疗的肠腔清洁要求。

Objective To compare the effectiveness and adverse effect of colon lavage device for intestinal cleansing in patients before colonoscopy. Methods Two hundred patients undergoing colonoscopy were randomly divided into 3 groups, namely oral mannitol group （group A）, colon lavage device group （group B） and colon lavage combined with oral mannitol group （group C）, The effects of the bowel preparations were evaluated on the basis of the degree of cleanness during colonoscopy and graded by the endoscopist according tO a 4-grade evaluation system. Results The bowel cleansing rate was 39.39% in group C, significantly higher than that in group A （ P 〈0.01） and group B （ P 〈0.01）, and the rate of bowel cleanness of grade Ⅰ orⅡ in group C was significantly higher than that in group A （P〈0.05） and group B （P〈0.05）. In group B, the cleansing rate of the bowel segment below the descending colon was 62. 86%, demonstrating a more satisfactory cleansing effect than that of group A （ P 〈0.05） and group C （ P 〈0.01）. The 3 bowel preparation measures were similar in terms of the adverse effects （ P 〈0.05）. Conclusions Oral mannitol combined with colon lavage device is safe and convenient for colon cleansing prior to colonoscopy and is associated with only mild adverse effects, especially suitable for colonoscopy of the descending colon, sigmoid colon and the rectum, Its combination with oral mannitol also meets the bowel condition demand of examination and treatment of the entire colon and even the lower segment of the ileum.