补救性口服1 L和2 L聚乙二醇方案对结肠镜检查前肠道准备不佳患者的改善效果研究

The improving effects of additional oral 1 L vs 2 L polyethylene glycol as rescue for patients with poor bowel preparation before colonoscopy

目的:探讨补救性口服1 L和2 L聚乙二醇(PEG)方案对结肠镜检查前肠道准备不充分患者的改善效果。方法:选取2019年3月至2019年10月门诊行筛查性结肠镜检查前经肛门末次排泄物性状初步评估为肠道准备不充分患者110例,随机分成1 L PEG组(n=55)和2 L PEG组(n=55),分别采取补救性口服1 L和2 L PGE方案提高肠道清洁度后,当天再尝试行结肠镜检查。对比两组以下指标:肠道清洁程度:全结肠和各段结肠波士顿肠道准备量表(BBPS)评分、肠道准备充分率,结肠镜检查结果:盲肠插管率、进镜时间、退镜时间、息肉检出率、腺瘤检出率,患者耐受性和满意度。结果:两组全结肠和各段结肠BBPS评分、肠道准备充分率比较,差异均无统计学意义(P>0.05)。两组盲肠插管率、进镜时间、退镜时间、息肉检出率、腺瘤检出率比较,差异均无统计学意义(P>0.05)。然而,1 L PEG组腹部不适发生率(38.2%vs 58.2%)显著低于2 L PEG组,满意度(7.8±1.5 vs 7.2±1.4)显著高于2 L PEG组,差异均具有统计学意义(P<0.05)。结论:补救性口服1 L和2 L PEG方案对结肠镜检查前不充分肠道准备的改善效果基本相似,均可确保当天结肠镜检查的顺利完成,尤其是接受1 L PEG补救性口服方案患者的耐受性和满意度更好。

Objective:To investigate the effect of remedial oral administration of 1 L vs 2 L polyethylene glycol(PEG)on the patients with inadequate bowel preparation before colonoscopy.Methods:From March 2019 to October 2019,110 outpatients patients with inadequate bowel preparation assessed by the last rectal effluent before colonoscopy,were randomly divided into 1 L PEG group(n=55)and 2 L PEG group(n=55).On the same day,the patients in the two groups were respectively given remedial oral 1 L or 2 L PGE and then underwent colonoscopy.The following indexes were compared between the two groups.Bowel cleanliness included the Boston bowel preparation score(BBPS)of whole colon and each segment of colon,the adequate rate of bowel preparation.Colonoscopy results included cecal intubation rate,cecal intubation time and withdrawal time,polyp detection rate,adenoma detection rate.Patient tolerance and satisfaction were observed.Results:There was no significant difference in BBPS score and the adequate rate of bowel preparation between the whole colon and each segment of the colon between the two groups(P>0.05).There were no statistically significant differences in cecal intubation rate,cecal intubation time and withdrawal time,polyp detection rate,and adenoma detection rate between the two groups(P>0.05).However,the incidence of abdominal discomfort(38.2%vs 58.2%)in the 1 L PEG group was significantly lower than that in the 2 L PEG group,and the satisfaction(7.8±1.5 vs 7.2±1.4)was significantly higher than that in the 2 L PEG group,with statistically significant differences(P<0.05).Conclusion:The effect of remedial oral 1 L or 2 L PEG on the improvement of inadequate intestinal preparation before colonoscopy is basically similar,which can ensure the successful completion of colonoscopy on the same day,especially the patients receiving 1 L PEG remedial oral regimen have better tolerance and satisfaction.