复方聚乙二醇联合西甲硅油在结肠镜检查术前肠道准备中的应用

Application of simethicone combined with compound polyethylene glycol in bowel preparation before colonoscopy

目的：探讨复方聚乙二醇联合西甲硅油在结肠镜检查术前肠道准备中的应用价值.方法：选取2014-01/2015-12于郑州大学附属郑州中心医院消化内科内镜中心行结肠镜检查的682例患者作为研究对象,根据其就诊次序进行编号,并随机分为观察组和对照组.对照组患者于术前6 h口服复方聚乙二醇电解质散;观察组患者在术前6 h口服复方聚乙二醇电解质散的基础上,于术前4 h口服二甲硅油乳剂30 m L.比较两组患者的肠道清洁度、祛泡效果、检查操作时间及术后腹痛、腹胀等不良反应情况差异.结果：两组患者的肠道清洁度满意率均较高,其中观察组为93.3%,对照组为90.0%,两组间的差异无统计学意义（χ^2=2.316,P=0.128）;观察组患者的祛泡满意率、祛泡一般率、严重气泡率分别为90.0%、8.2%及2.8%,对照组患者的祛泡满意率、祛泡一般率、严重气泡率分别为86.5%、7.0%、6.5%,观察组的祛泡效果明显优于对照组,且两组间的差异具有统计学意义（χ^2=9.690,P=0.008）;观察组患者接受结肠镜检查的平均时间为11.6 min±3.1 min,低于对照组患者接受结肠镜检查的时间（12.3 min±3.8 min）,且两组间的差异具有统计学意义（t=2.636,P=0.009）.在术后不良反应方面,两组患者的腹痛发生率间的差异无统计学意义（χ^2=1.951,P=0.163）;但观察组患者的腹胀发生率为10.6%,明显低于对照组的16.7%,且差异具有统计学意义（χ^2=5.491,P=0.019）.结论：复方聚乙二醇联合西甲硅油应用于结肠镜检查术前肠道准备工作中,可明显祛除肠道气泡,提高视野清晰度,利于检查者的操作,缩短检查时间,同时也可降低术后患者腹胀的发生率,适合应用于结肠镜检查的术前肠道准备.

AIM ： To assess the application value of simethicone combined with compound polyethylene glycol in bowel preparation before colonoscopy.METHODS： Six hundred and eighty-two patients who underwent colonoscopy at our hospital from January 2014 to December 2015 were selected. They were randomly divided into either an observation group or a control group according to the order of treatment. Patients in the control group were orally administered with polyethylene glycol electrolyte powder 6 h before colonoscopy, and patients in the observation group were orally administered with simethicone 4 h before colonoscopy and polyethylene glycol electrolyte powder 6 h before colonoscopy. Intestinal cleanliness, bubble-removing effect, duration of colonoscopy, abdominal pain, abdominal distension and other adverse reactions were compared between the two groups.RESULTS： The rate of satisfying intestinal cleanliness were high in both groups, and there was no significant difference between the two groups（observation group 93.3% vs control group 90.0%, χ~2 = 2.316, P = 0.128）. The rates of satisfying bubble removal and acceptable bubble removal and the rate of severe bubbles were 90%, 8.2%, and 2.8%, respectively, in the observation group, and the corresponding percentages in the control group were 86.5%, 7%, and 6.5%, and there were significant differences between the two groups（χ~2 = 9.690, P = 0.008）. The average duration of colonoscopy was 11.6 min ± 3.1 min in the observation group, which was significantly lower than that of the control group（12.3 min ± 3.8 min, t = 2.636, P = 0.009）. The rate of abdominal pain did not differ significantly between the two groups（χ~2 = 1.951, P = 0.163）; but the incidence of abdominal distension was 10.6% in the observation group, which was significantly lower than that in the control group（χ~2 = 5.491, P = 0.019）.CONCLUSION： Application of simethicone combined with compound polyethylene glycol in bowel preparation for colonoscopy could obviously remove intestinal bubbles, improve the visualization, shorten the examination time, and reduce the incidence of abdominal distension.