不同剂量聚乙二醇电解质溶液行结肠镜检查肠道准备的比较性分析

Comparative analysis of different doses of polyethylene glycol electrolyte solution for colonoscopy preparation

目的：比较不同剂量聚乙二醇电解质溶液行结肠镜检查肠道准备的效果，以及患者的依从性、耐受性和不良反应情况。方法采用随机、单盲、前瞻性研究方法，将2014年5月至2014年7月期间100例进行结肠镜检查的住院患者按当天结肠镜检查时间顺序随机分成3组，分别在结肠镜检查当天服用聚乙二醇电解质溶液4 L（35例）、2 L（31例）和（2＋1）L（34例）。检查时分别对右半结肠、中段结肠和左半结肠的肠道准备效果进行渥太华量表评分，并观察总液体量进行评分，得出渥太华量表综合评分。同时对每位患者进行问卷调查，记录3组患者的依从性、耐受性及不良反应情况，进行统计学分析。结果剔除未能完成全结肠检查病例，纳入分析患者91例，其中4 L 组31例，2 L组30例，（2＋1）L 组30例。3组患者聚乙二醇电解质溶液肠道准备的渥太华量表综合评分相似（P ＞0.05），但4 L 组患者右半结肠清洁质量高于2 L 组患者（P ＜0.05）。与4 L 组和（2＋1）L组比较，采用2 L 聚乙二醇电解质溶液组的患者肠道准备的依从性和耐受性较高，不良反应率较低（P ＜0.05）。结论结肠镜检查当天服用2 L 聚乙二醇电解质溶液进行肠道准备的清洁效果和安全性较好，适合推广使用。当天服用4 L 聚乙二醇电解质溶液进行肠道准备方案，更适用于高度怀疑右半结肠病变的患者。

Objective To compare the efficacy of bowel-cleansing,patients′compliance, tolerability and side effects of different doses of polyethylene glycol（PEG）electrolyte solution for colonoscopy preparation.Methods Single-blind prospective randomized trial was performed.A total of 100 inpatients undergoing elective colonoscopy were randomized into three groups to receive 4 L PEG（n =35）,2 L PEG （n =31）or 2 ＋1 L PEG（n =34）,respectively,on the day of colonoscopy from May to July 2014.Bowel-cleansing efficacy was separately assessed with the Ottawa Scale for the right,middle,and left colon.Total score was obtained by adding the scores for individual evaluation of the three colon segments with the score of overall fluid in the entire colon.All patients filled in a questionnaire and were interviewed about their com-pliance to the assigned bowel preparation,tolerability,and side effects.Results Patients who did not complete the colonoscopy were excluded.A total of 91 patients were included in the last analysis：31 cases of 4 L group,30 cases of 2 L group and 30 cases of 2 ＋1 L group.The efficacy of bowel-cleansing of the three groups of patients according to the Ottawa Scale were similar（P〉0.05）,but the excellent and good rate of cleansing quality of the right colon was higher in 4 L group than in 2 L group（P 〈0.05）.Compared with 4 L group and 2 ＋1 L group,patients in the 2 L group had higher compliance and tolerability,as well as lower rate of side effects（P 〈0.05 ）.Conclusion The efficacy and safety of taking 2 L polyethylene glycol electrolyte solution in bowel-cleansing on the day of colonoscopy is good and suitable for use.Taking 4 L＆amp;nbsp;polyethylene glycol electrolyte solution for bowel preparation on the day of colonoscopy is more suitable for patients who are suspected highly with lesions of the right colon.