聚乙二醇联合低剂量硫酸镁在2型糖尿病患者结肠镜肠道准备中的应用价值

Application value of polyethylene glycol combined with low dose magnesium sulfate in bowel preparation for colonoscopy of patients with type 2 diabetes mellitus

目的:探讨聚乙二醇联合低剂量硫酸镁在2型糖尿病患者结肠镜肠道准备中的应用价值。方法:前瞻性纳入120例2型糖尿病结肠镜肠道准备患者,随机分为常规组和联合组两组,每组60例。常规组采用聚乙二醇3 L分割剂量方案,联合组在常规组方案基础上再口服50 ml 50%硫酸镁溶液。两组患者健康宣教和饮食调整方法相同。由一名单盲状态的内镜医师采用波士顿肠道准备评分量表(BBPS)评估两组患者肠道清洁质量,包括全结肠BBPS得分、肠道准备充分(BBPS≥6分,且各段结肠评分均≥2分)率、各段结肠(升结肠-盲肠段、横结肠-降结肠段、直肠-乙状结肠段)BBPS得分和BBPS<2分的比例,使用自制调查问卷评估两组患者肠道准备的耐受性和不良反应(恶心/呕吐、腹胀、腹痛、直肠烧灼感)。结果:联合组全结肠BBPS得分(7.7±1.3比7.1±1.5)、肠道准备充分率(90%比75%)显著高于常规组(P<0.05)。联合组升结肠-盲肠段(2.4±0.4比2.1±0.5)、横结肠-降结肠段(2.7±0.5比2.5±0.5)BBPS得分显著高于常规组(P<0.05),且上述2段结肠BBPS<2分患者比例(1.7%比11.7%;0比8.3%)显著低于常规组(P<0.05),两组直肠-乙状结肠段BBPS得分和BBPS<2分患者比例差异未见统计学意义(P>0.05)。两组肠道准备不良反应和耐受性差异未见统计学意义(P>0.05)。结论:聚乙二醇联合低剂量硫酸镁可以提高2型糖尿病患者结肠镜肠道准备质量,且并不增加不良反应发生风险。

Objective:To investigate the value of polyethylene glycol(PEG) combined with low dose magnesium sulfate in bowel preparation for colonoscopy of patients with type 2 diabetes mellitus.Methods:A consecutive series of 120 patients with type 2 diabetes mellitus undergoing colonoscopic bowel preparation were randomly divided into two groups:Conventional group and combined group,60 cases in each group.The conventional group was given PEG 3 L split-dose regimen,and the combined group was given 50 ml 50% magnesium sulfate solution on the basis of conventional regimen.The health education and diet adjustment methods of the 2 groups were the same.Boston Bowel Preparation Scale(BBPS) was used to assess the bowel cleanliness of the two groups by a blind endoscopist,including the total colon BBPS score,the rate of adequate bowel preparation(BBPS ≥6,and three segmental score≥2),the three segmental score of colon(ascending colon-cecum segment,transverse colon-descending colon segment,rectum-sigmoid segment),and the rate of segmental score <2.The tolerance and adverse reactions(nausea/vomiting,abdominal distention,abdominal pain,rectal burning) of bowel preparation were assessed with a self-designed questionnaire.Results:The BBPS score and bowel preparation adequate rate in the combined group were significantly higher than those in the conventional group(P<0.05).The BBPS scores of ascending colon-cecum segment and transverse-descending colon segment in the combined group were significantly higher than those in the conventional group(P<0.05),and the proportion of BBPS <2 in the both colon segments was significantly lower than that in the conventional group(P<0.05).There was no significant difference in BBPS score and proportion of BBPS <2 of rectum-sigmoid segment between the two groups(P>0.05).There was no significant difference in bowel preparation safety and tolerance between the two groups(P>0.05).Conclusion:PEG combined with low dose magnesium sulfate can improve the quality of bowel preparation for type 2 diabetes without increasing the risk of adverse reactions.