结肠镜检查前口服复方聚乙二醇联合西甲硅油方案中西甲硅油的不同服用时间对肠道清洁度程度、腺瘤及息肉检出率的影响

Effect of compound polyethylene glycol combined with simethicone administered at different time before colonoscopy on intestinal cleanliness, detection rate of adenoma and polyp

目的 研究结肠镜检查前口服复方聚乙二醇联合西甲硅油方案中西甲硅油的不同服用时间对肠道清洁度程度、腺瘤、息肉检出率的影响。方法 将2020年2月至2022年6月在六安市中医进行结肠镜检查的105例患者纳入本次前瞻性研究,根据随机数字表法分为观察1组(n=35)、观察2组(n=35)和观察3组(n=35)。所有患者均在结肠镜检查前6 h口服聚乙二醇电解质散清洁肠道,观察1组、观察2组和观察3组患者分别在结肠镜检查前2 h、1 h和0.5 h口服西甲硅油30 mL。比较3组患者的检查前肠道清洁度、肠道气泡消除情况、进镜时间、退镜时间、镜头清晰度、0.9%氯化钠溶液冲洗量、肠道息肉和腺瘤检出率。结果 3组患者检查前肠道清洁度评分差异无统计学意义(P>0.05);观察2组患者的肠道气泡评分为(8.09±0.89)分,显著高于观察1组和观察3组[(7.55±0.94)分和(7.60±0.81)分],差异有统计学意义(P<0.05)。3组的进镜时间和退镜时间差异无统计学意义(P>0.05);观察2组的镜头清晰度评分、0.9%氯化钠溶液冲洗量分别为(0.72±0.28)分、(15.62±5.50) mL,均低于观察1组和观察3组[镜头清晰度评分为(0.87±0.32)、(0.92±0.30)分;0.9%氯化钠溶液冲洗量为(20.56±5.84)mL、(23.20±6.03)mL],差异均有统计学意义(P<0.05)。3组患者的>5 mm肠道息肉检出率、肠道息肉总检出率和腺瘤检出率差异均无统计学意义(P>0.05),但观察2组患者≤5 mm肠道息肉检出率为17.14%,显著高于观察1组和观察3组(均为2.86%),差异有统计学意义(P<0.05)。结论 结肠镜检查前口服复方聚乙二醇联合西甲硅油方案中西甲硅油的不同服用时间对肠道清洁度、腺瘤检出率无影响,但检查前1 h口服西甲硅油提高细小息肉的检出率,能更有效的消除肠道气泡,获得更好的肠道清晰度。

Objective To study the effect of compound polyethylene glycol combined with simethicone administered at different time before colonoscopy on intestinal cleanliness, detection rate of adenoma and polyp. Methods One hundred patients who underwent colonoscopy in Lu’an Hospital of Traditional Chinese Medicine from February 2020 to June 2022 were enrolled in this prospective study. According to the random number table, they were divided into observation group 1(n=35), observation group 2(n=35) and observation group 3(n=35). All patients were given polyethylene glycol electrolyte powder to clean their intestines 6 hours before colonoscopy. Patients in observation group 1, group 2 and group 3 were treated with 30 mL simethicone 2 h, 1 h and 0.5 h before colonoscopy, respectively. The following indexes: intestinal cleanliness before examination, intestinal bubble elimination, entry time, exit time, lens sharpness and saline rinsing volume, detection rate of intestinal polyps and adenomas were compared. Results There was no significant difference on intestinal cleanliness score among the three groups before examination(P>0.05). The intestinal bubble score of the observation group 2 was(8.09±0.89) pionts, which was much higher than that of the observation group 1 and the observation group 3 [(7.55±0.94) pionts and(7.60±0.81) pionts], the difference was statistically significant(P<0.05). Entry time and exit time among the three groups was no significant difference(P>0.05). The lens sharpness score and saline rinse volume of the observation group 2 were(0.72±0.28) pionts,(15.62±5.50) mL, which were dramatically lower than those of the observation group 1 and the observation group 3 [lens sharpness score were(0.87±0.32),(0.92±0.30) pionts and saline rinsing volume were(20.56±5.84) mL,(23.20±6.03) mL], the differences were statistically significant(P<0.05). The difference on the detection rate of >0.5 cm intestinal polyps, total intestinal polyps and adenoma among the three groups was not statistically significant(P>0.05), but the detection rate of≤5 mm intestinal polyps in the observation 2 group was 17.14%, which was apparently higher than that in the other two groups(both 2.86%), the difference was statistically significant(P<0.05). Conclusion The oral administration of compound polyethylene glycol combined with simethicone at different time before colonoscopy has no effect on intestinal cleanliness and detection rate of adenoma, but oral administration of simethicone 1 h before examination can improve the detection rate of small polyps, effectively eliminate intestinal bubbles and obtain good intestinal clarity.