聚乙二醇电解质散与磷酸钠盐口服液在结直肠癌手术肠道清洁中的效果分析

Effect of polyethylene glycol electrolyte powder and sodium phosphate oral on bowel cleaning in the colorectal cancer surgery

目的比较口服聚乙二醇(PEG)电解质散与磷酸钠盐口服液在结直肠癌手术肠道清洁中的应用效果。方法选择86例结直肠癌手术患者,采用信封法随机分为2组,每组43例。所有患者术前3 d起进半流质饮食,术前1 d进流质饮食。PEG组采用PEG电解质散,1 L/h,每次1 L。磷酸钠盐组每次取45 mL磷酸钠盐溶液,以750 mL温凉开水稀释后服用。分别在检查前10、4 h时各服药1次。由内镜医师在在结肠镜检查时,根据肠腔内粪便量、形态及肠黏膜清晰度评价肠道清洁效果,仔细观察并记录两组患者腹痛、腹胀、恶心等不良反应发生情况,同时观察比较两组患者术后出现肠鸣音时间、排气时间等,并检测两组患者术前肠道准备前后血电解质情况。结果 PEG组清肠效果优良率为97.67%,磷酸钠盐组优良率为83.72%,PEG组清肠效果优于磷酸钠盐组(P<0.05)。PEG组不良反应发生率低于磷酸钠盐组(P<0.05),肠鸣音出现时间及排气时间均较磷酸钠盐明显缩短(P<0.05),PEG组腹泻次数明显低于磷酸钠盐组(P<0.05)。PEG组清洁肠道后各项电解质水平与清洁肠道前比较差异无统计学意义(P>0.05),均在正常范围内,而磷酸钠盐组血氯、钠、磷较灌肠前显著升高(P<0.05)。结论采用PEG电解质散口服作为结直肠癌手术术前肠道清洁的效果优于口服磷酸钠盐口服液,而且安全性更高,患者耐受性更好,是更为优良的术前肠道准备用药。

Objective To compare the effect of oral polyethylene glycol electrolyte powder（PEG） and sodium phosphate oral solution on intestinal cleaning in the colorectal cancer operation. Methods 86 patients with colorectal cancer operation were randomly divided into 2 groups using the envelope method ,43 cases in each group. All the patients were given semi liquid diet and liquid diet at 3 d and 1 d before operation. PEG group received PEG electrolyte powder（ 1 L/h）, 1 L per time. Sodium phosphate group was given 45 mL sodium phosphate solution diluted in 750 mL of cool boiling water. The medication was given at 10 h and 4 h before examination each time. The intestinal cleaning effect was evaluated by the colonoscopy endoscopist according to the intraluminal stool volume, morphology and intestinal mucosa definition carefully. The occurrence of adverse reactions was observed and recorded, such as abdominal pain, abdominal distention, nausea, and the postoperative bowel sound time, discharge time and detection of serum electrolyte bowel preparation before operation in the two groups were recorded. Results The excellent rate of intestinal cleaning effects in PEG group and sodium phosphate group were 97.67% and 83.72% ,there were significant difference between the two groups （ P 〈 0.05 ）. The adverse reaction rate in group PEG was significantly lower than that of sodi- um phosphate group（ P 〈 0.05 ）. The number of diarrhea in PEG group was significantly lower than that of sodium phosphate group, and the bowel sound time and discharge time in PEG group were obviously shorter than those of sodium phosphate group, there were significant differences between the two groups （ P 〈 0.05 ）. No significant difference was found in the electrolyte level in PEG group before and after the intestinal cleaing （P 〉 0.05 ） , and the level was in the normal range;while the sodium phosphate, sodium and chloride in phosphorus group increased significantly after the intestinal cleaning （ P 〈 0.05 ）. Conclusion The PEG electrolyte powder orally is better than oral sodium phosphate oral liquid in the intestinal cleaning before the colorectal cancer surgery with higher security and tolerance, it is a more excellent preparation for bowel surgery.