低剂量聚乙二醇联合硫酸镁用于肠道准备的效果评价

Evaluation of Low-dose Polyethylene Glycol Combined with Magnesium Sulfate in Bowel Preparation

背景:聚乙二醇(PEG)为临床常用肠道准备清洁剂,但仍存在一些缺点。笔者等设计了一种低剂量PEG联合低剂量硫酸镁的肠道准备方案,以期能减少PEG溶液摄入量,提高肠腔清洁程度,减少气泡,缩短结肠镜检查时间。目的:以标准剂量PEG方案为对照,评价新方案在结肠镜检查前肠道准备中的有效性、耐受性、安全性以及合适的给药时机。方法:连续收集拟行结肠镜检查者180例,随机分为三组。A组服用标准剂量PEG(68.56 g/包×2包)、B组连续服用低剂量PEG(1包)和硫酸镁(25%,60 ml)、C组间断服用低剂量PEG和硫酸镁行肠道准备。内镜医师单盲行Boston肠道准备量表(BBPS)和肠腔内气泡评分,记录结肠镜检查时间。问卷调查患者对药物的耐受性,记录服药后不良反应。监测用药前后心率、血压和实验室指标。结果:所有患者均完成肠道准备和全结肠镜检查。B、C两组BBPS总分显著高于A组(P<0.05),结肠镜检查时间显著短于A组(P<0.05),B组肠腔内气泡评分显著低于A、C两组(P<0.05)。B、C两组药物口感评分、完全服用率和愿意再服率均高于A组。三组间总体不良反应评分无明显差异。结论:与标准剂量PEG方案相比,连续服用低剂量PEG和低剂量硫酸镁用于结肠镜检查前肠道准备更为有效,耐受性更高;两种方案安全性相似。

Background： Polyethylene glycol（PEG） is a commonly used cleaning agent for bowel preparation in clinical practice,however,it still has some disadvantages.We designed a new bowel preparation regimen containing low-dose PEG and low-dose magnesium sulfate to decrease the volume of PEG solution ingested,improve the cleanliness of intestine,reduce the air bubbles,and shorten the procedure time of colonoscopy.Aims： To evaluate the efficacy,tolerance,safety and appropriate time of administration of this new regimen in bowel preparation for colonoscopy by comparing with the standard dose PEG regimen.Methods： One hundred and eighty consecutive patients referred for colonoscopy were prospectively enrolled and randomly divided into three groups.Group A received standard dose PEG（68.56 g/pack × 2 packs）,Group B received low-dose PEG（1 pack） and magnesium sulfate（25%,60 ml） in continuation,and Group C received low-dose PEG and magnesium sulfate intermittently for bowel preparation.Score of Boston bowel preparation scale（BBPS） and bubbles in bowel lumen were assessed by endoscopists blindly to the preparation regimen,and the procedure time of colonoscopy was recorded.A questionnaire was used to assess patients＇ tolerance,and the adverse effects after taking the solution were recorded.Heart rate,blood pressure and various laboratory parameters were monitored before and after preparation.Results： All patients completed the bowel preparation and colonoscopy.Total BBPS score was higher（P0.05） and procedure time of colonoscopy was shorter（P0.05） in Group B and Group C than in Group A,while bubbles in bowel lumen were less（P0.05） in Group B than in Group A and Group C.Taste score,rate of taking the solution completely and willingness to retake in Group B and Group C were superior to those in Group A.No significant difference was found in score of total adverse effects between the three groups.Conclusions： Low-dose PEG and low-dose magnesium sulfate in continuation is more effective and tolerated than standard dose PEG regimen in bowel preparation for colonoscopy.Both regimens are safe.