不同口服肠道准备法对老年便秘患者结肠镜检查的效果

Comparison of different methods of bowel preparation before colonoscopy in elderly patients with chronic constipation

目的探讨用于老年慢性便秘患者安全及有效的肠道准备方法,以提高结肠镜检查的成功率。方法选择2009年7月—2010年7月在上海交通大学附属第六人民医院拟行电子结肠镜检查的老年慢性便秘患者150例,随机分为A组、B组和C组各50例;肠道准备:A组采用复方聚乙二醇电解质散,B组采用番泻叶、甘露醇和口服补液盐,C组采用番泻叶和复方聚乙二醇电解质散。观察并详细记录肠道准备效果,肠镜检查中肠道清洁程度,患者的依从性和不良反应发生情况。结果①C组的肠道清洁度有效率为94.0%,高于A组的66.0%和B组的74.0%;②3组均无严重不良反应发生,C组的不良反应发生率为10.0%,低于A组的26.0%和B组的30.0%。A组与B组在清洁效果与不良反应发生率方面差异均无统计学意义(P>0.05),C组与A组和B组比较,差异有统计学意义(P<0.05)。结论采用口服番泻叶和复方聚乙二醇电解质散应用于老年慢性便秘者的肠道准备效果满意,不良反应小,可提高患者结肠镜检查的成功率,使患者得到及时的诊疗。

Objective To explore the safe and effective method of bowel preparation to increase the success rate of colonoscopy and patient compliance,and reduce adverse reactions and colonoscopy complications in elderly patients with chronic constipation.Methods From July 2009 to July 2010 a total of 150 elderly patients with chronic constipation in our hospital undergoing colonoscopy were randomly and equally divided into groups A,B and C.They were given compound polyethylene glycol electrolyte powder（group A）,senna,mannitol and oral rehydration salts（group B）,and senna and polyethylene glycol electrolyte bulk compound（group C） as bowel preparation medication respectively.During the bowel preparation the effect of bowel preparation,effective rate of bowel cleanness,patient compliance and incidence of adverse reactions were observed and recorded in detail.Results The effective rate of bowel cleanness in group C was 94.0%,higher than 66.0% in group A and 74.0% in group B.There were no serious adverse events in three groups.The adverse reaction rate in group C was 10.0%,lower than 26.0% in group A and 30.0% in group B.There were no significant differences in the bowel cleanness and adverse reaction rate between group A and group B（P0.05）,but there were significant differences comparing group C with group A and group B（P0.05）.Conclusion The application of senna and polyethylene glycol electrolyte bulk compound in bowel preparation in elderly patients with chronic constipation is effective,with little adverse reactions and high colonoscopy success rate.