聚乙二醇电解质散联合橄榄油在不同便秘程度患者中肠道准备的效果

The effect of taking polyethylene glycol electrolyte powder combined with olive oil during bowel preparation for chronic constipation patients with different degrees

目的探讨聚乙二醇电解质散(polyethylene glycol electrolyte powder,PEG-ELP)联合橄榄油使用在不同慢性便秘严重程度患者中肠道准备的效果。方法将2017年11月至2018年12月于空军军医大学唐都医院接受结肠镜检查的320例慢性便秘患者随机分为干预组和对照组,每组各160例,依据便秘严重程度为轻度、中度和重度的评分将干预组分为A、B、C三组,将对照组分为D、E、F三组。其中干预组在肠道准备时服用橄榄油60 ml+PEG-ELP 3000 ml,对照组仅服用PEG-ELP 3000 ml,之后记录每例患者服用PEG-ELP后的首次排便时间、入眠前排便次数、排便总次数和肠道准备过程中的不良反应,并在检查时对肠道准备的效果采用波士顿肠道准备评估量表(BBPS)进行计分。结果A组与D组、B组与E组、C组与F组患者之间的一般资料比较,差异无统计学意义(P>0.05),分别比较A组与D组、B组与E组中患者服用PEG-ELP后的排便情况及BBPS评分,其服用PEG-ELP后的首次排便时间、入眠前排便次数和排便总次数比较,差异均无统计学意义(P>0.05),组间BBPS评分差异无统计学意义(P>0.05)。C组与F组之间,C组首次排便时间明显缩短[(2.20±2.34)min vs(3.33±2.87)min,P=0.013];入眠前排便次数明显增多[(3.52±1.94)次vs(2.55±1.72)次,P=0.002)];排便总次数也明显增多[(7.33±2.49)次vs(5.81±2.27)次,P=0.001];且C组患者BBPS评分优于F组患者,差异均有统计学意义(P<0.05),其中左侧结肠评分[(2.09±0.75)分vs(1.78±0.84)分,P=0.024]、中段结肠评分[(2.60±0.70)分vs(2.27±0.93)分,P=0.023]、右侧结肠评分[(2.06±0.83)分vs(1.47±0.85)分,P=0.001]及总体BBPS评分[(6.75±2.00)分vs(5.55±2.33)分,P=0.001]。干预组与对照组在肠道准备过程中的不良反应率比较,差异无统计学意义(P>0.05)。结论PEG-ELP联合橄榄油的肠道准备方法可缩短重度慢性便秘患者服用PEG-ELP后的首次排便时间,增加入眠前排便次数和排便总次数,尤其可明显提高重度慢性便秘患者全结肠的肠道清洁度,且无明显的不良反应,为改善肠道准备效果较差的便秘患者肠道准备方法提供了新的临床思路。

Objective To investigate the effect of taking polyethylene glycol electrolyte powder(PEG-ELP)combined with olive oil during bowel preparation for chronic constipation patients with different degrees.Methods 320 patients with chronic constipation in Tangdu Hospital,Air Force Medical University were randomly assigned as intervention group(160 patients)and control group(160 patients).All patients did their colonoscopies from Nov.2017 to Dec.2018.And then according to the degrees of constipation were mild,moderate and severe,the intervention group was divided into group A,B,C,the control group was divided into group D,E,F.Patients in group A,B,C took 60 ml olive oil+3000 ml PEG-ELP.Patients in group D,E,F only took PEG-ELP 3000 ml.The time of first defecation after taking the medication,the total numbers of defecation before getting sleep,the total numbers of defecation and the adverse reactions in bowel preparation were compared.The bowel preparation scores were kept by BBPS.Results There were no statistical differences between group A and D,B and E,C and F based on the general resource(P>0.05).After stratified comparative analysis,there was no significant difference in the time for the first defecation after taking the medication,the numbers of defecation before getting sleep,and the total numbers of defecation between group A and D,B and E.And there was no significant difference in BBPS between group A and D,B and E.For group C,the time for their first defecation after taking the medication was shorter[(2.20±2.34)min vs(3.33±2.87)min,P=0.013],the numbers of defecation before getting sleep were higher[(3.52±1.94)times vs(2.55±1.72)times,P=0.002],the total numbers of defecation were higher than group F[(7.33±2.49)times vs(5.81±2.27)times,P=0.001].The scores of the left colon[(2.09±0.75)scores vs(1.78±0.84)scores,P=0.024],the middle colon[(2.60±0.70)scores vs(2.27±0.93)scores,P=0.023],the right colon[(2.06±0.83)scores vs(1.47±0.85)scores,P=0.001]and the total BBPS scores[(6.75±2.00)scores vs(5.55±2.33)scores,P=0.001]for group C were both higher than group F(P<0.05).There was no statistically significant difference in adverse reactions between the intervention group and the control group during bowel preparation(P>0.05).Conclusion The bowel preparation method of PEG-ELP combined with olive oil can shorten the first defecation time of patients with severe chronic constipation after taking PEG-ELP,increase the numbers of defecation before getting sleep and the total numbers of defecation,especially significantly improve the whole colon cleanliness of patients with severe chronic constipation,without obvious adverse reactions.It provides a new clinical idea for improving bowel preparation for constipation patients.