利那洛肽联合复方聚乙二醇电解质在慢性便秘患者肠道准备中的临床应用

Clinical Application of Linaclotide Combined with Compound Polyethylene Glycol Electrolyte in Bowel Preparation in Patients with Chronic Constipation

目的研究利那洛肽联合复方聚乙二醇电解质(PEG)在慢性便秘患者肠道准备中的效果及安全性。方法选取2021年3月至2022年2月在青岛市第八人民医院行结肠镜检查的174例慢性便秘患者作为研究对象,采用随机数字表法分为A组、B组、C组,每组各58例。A组患者采用3LPEG分次清肠,B组患者采用3粒利那洛肽联合3LPEG分次清肠,C组患者采用4LPEG分次清肠。比较3组患者的肠道准备质量、结肠镜检查时间及不良反应发生率。结果B组和C组的左半结肠、横结肠、右半结肠评分及Boston肠道准备量表(BBPS)总评分均高于A组(P<0.05);B组的左半结肠、横结肠、右半结肠评分及BBPS总评分与C组比较,差异无统计学意义(P>0.05)。老年便秘患者中,B组的左半结肠、横结肠、右半结肠评分及BBPS总评分与C组比较,高于C组(P<0.05)。B组和C组进境时间、退镜时间、肠镜总时间均小于A组(P<0.05);B组的进境时间、退镜时间、肠镜总时间与C组比较,小于C组(P<0.05)。A组和B组与C组比较,每项不良反应发生率均小于C组(P<0.05)。结论利那洛肽联合分次口服3LPEG相对单独分次口服3LPEG而言,提高了肠道准备质量并缩短了结肠镜检查时间,相对单独分次口服4LPEG而言,可以达到同样的肠道准备效果,且可以降低不良反应的发生率,安全性较高。对于老年慢性便秘患者,利那洛肽联合分次口服3LPEG与单独分次口服4LPEG比较,肠道准备效果更佳。

Objective To study the effect and safety of linaclotide combined with compound polyethylene glycol electrolyte( PEG) in bowel preparation in patients with chronic constipation. Methods A total of 174patients with chronic constipation who underwent colonoscopy in Qingdao Eighth People’s Hospital from March2021 to February 2022 were selected as the research subjects,and they were divided into group A,group B,and group C by random number table method,with 58 cases in each group. Patients in group A were treated with 3LPEG fractionated bowel cleansing,patients in group B were treated with 3 capsules of linaclotide combined with 3LPEG fractional bowel cleansing,and group C patients were given 4LPEG fractional bowel cleansing.The quality of bowel preparation,colonoscopy time and incidence of adverse reactions were compared among the three groups.Results The scores of the left semicolon,transverse colon,right semicolon and Boston bowel preparation scale(BBPS) total score in groups B and C were higher than those in group A (P<0.05).There was no significant difference in the scores of the left semicolon,transverse colon,right semicolon and total BBPS score between group B and group C (P>0.05).Among the elderly patients with constipation,the scores of the left semicolon,transverse colon,right semicolon and BBPS total score in group B were higher than those in group C (P<0.05).The entry time,exit time and total colonoscopy time of groups B and C were all shorter than those of group A (P<0.05).Compared with group C,the entry time,exit time and total colonoscopy time of group B were shorter than those of group C(P<0.05).Compared with group C,the incidence of each adverse reaction in groups A and B was lower than that in group C (P<0.05).Conclusions Linaclotide combined with fractional oral 3LPEG improves the quality of bowel preparation and shortens the time of colonoscopy compared with single fractional oral 3LPEG.Compared with fractional oral 4LPEG alone,it can achieve the same bowel preparation effect and can reduce the incidence of adverse reactions,with high safety.For elderly patients with chronic constipation,linaclotide combined with fractional oral 3LPEG has a better bowel preparation effect than fractional oral 4LPEG alone.