聚乙二醇电解质联合二甲基硅油对结肠镜检查肠道准备的影响

Use of polyethylene glycol electrolyte powder combined with dimethicone powder in bowel preparation for colonoscopy

目的:观察聚乙二醇电解质联合口服二甲基硅油用于结肠镜检查肠道准备的临床效果,以寻找一种最有效和耐受性良好的肠道准备方法,提高肠镜检查的成功率.方法:选择2014-05/2015-05在天津海滨人民医院消化内科进行结肠镜检查的患者共400例,随机分成对照组和观察组,每组患者200例.对照组口服聚乙二醇电解质;观察组在对照组的基础上加服二甲基硅油散.利用Boston肠道准备度量表(Boston Bowel Preparation scale,BBPS)对肠道清洁度进行评分;对各肠段的气泡量进行盲法评价;比较两组患者腹痛腹胀的耐受性及息肉检出率;记录结肠镜到达回盲部所用时间.结果:(1)两组肠道清洁度比较,无显著性差异(P>0.05);(2)与对照组相比,观察组的气泡量、患者耐受情况均优于对照组,与对照组中喷洒二甲基硅油散溶液前和喷洒二甲基硅油散溶液后分别相比,观察组的息肉检出率均较高(33.50%vs 24.50%,P<0.05)、(33.50%vs 32.50%,P<0.05),差异有统计学意义;(3)结肠镜到达回盲部的时间,两组比较无统计学意义.结论:聚乙二醇电解质联合二甲基硅油可改善肠道清洁程度,减轻患者腹部疼痛感,提高耐受性,提高息肉的检出率,结肠镜检查前加服二甲基硅油能安全有效地改善肠道准备效果.

AIM： To assess the efficacy of polyethylene glycol electrolyte powder combined with dimethicone powder in bowel preparation for colonoscopy and find the most efficacious and well-tolerated bowel preparation measure to improve the success rate of colonoscopy.METHODS： Four hundred patients undergoing colonoscopic examination at Department of Gastroenterology of our hospital form May2014 to May 2015 were randomly divided into an observation group and a control group,with 200 cases in each group. The control group was given oral polyethylene glycol electrolyte powder alone, and the observation group was additionally given dimethicone on the basis of oral polyethylene glycol electrolyte powder. Intestinal cleanliness was scored with the Boston bowel preparation scale（BBPS）. Intraluminal gas bubbles were graded in different bowel sections. The degree of tolerance to abdominal distension and abdominal pain, and polyp detection rate were compared and analyzed. The time for colonoscope to reach the ileocecal junction was monitored.RESULTS： There was no significant difference between the two groups in terms of intestinal cleanliness（P〉0.05）. The intestinal bubble score, the degree of tolerance to abdominaldistension and abdominal pain, and the colonoscopic polyp detection rate of the observation group were significantly superior to those of the control group（P〈 0.05）. There was no significant difference in the time for colonscope to reach the ileocecal junction between the two groups.CONCLUSION： Polyethylene glycol electrolyte powder combined with dimethicone powder can improve intestinal cleanliness, reduce pain, improve tolerance, and increase the polyp detection rate. Colonic preparation can be safely and effectively improved by taking dimethicone before colonoscopic examination.