利那洛肽联合2L聚乙二醇电解质散在肠道准备中的应用价值

Effect of 2L compound polyethylene glycol electrolyte combined with Linalotide on bowel preparation before colonoscopy

目的 探讨利那洛肽联合分次小剂量聚乙二醇电解质散(polyethylene glycol electrolytes powder,PEG)在结肠镜检查肠道准备中的应用价值。方法 采用前瞻性随机对照研究,纳入2023年2月至2023年7月于襄阳市中心医院消化内科住院行结肠镜检查的221名患者,随机分为3组,A组采用2L PEG,B组采用580μg利那洛肽+2L PEG,C组为对照组采用3L PEG,PEG均是分次剂量服用方案。比较三组的肠道清洁度(BBPS评分)、病变检出率、首次排便间隔时间及总排便次数、不良反应发生率、患者服药完成度等指标。结果 B组在回肠末端、右半结肠、全结肠总评分上肠道清洁效果均优于A组[(1.90±0.46)分VS (1.64±0.42)分、(1.84±0.35)分VS(1.58±0.46)分、(6.70±0.92)分VS (6.24±0.98)分],差异均有统计学意义(P<0.05);B组与C组,在不同肠段以及全结肠总评分上差异均无统计学意义(P>0.05) B组、C组BBPS评分高于A组[总评分(6.70±0.92)、(6.75±0.86)VS(6.24±0.98),P<0.05],差异有统计学意义。三组患者息肉、腺瘤、回肠末端的病变检出率差异无统计学意义(P>0.05)。B组的首次排便间隔时间短于A组和C组[(0.98±0.61)h VS(1.46±1.61) h VS(1.64±1.89)h,(P<0.05)],差异有统计学意义;B组和C组的总排便次数高于A组[(10.51±3.28)次VS (10.96±3.23)次VS (8.65±2.20)次,(P<0.05)],差异有统计学意义。A组、B组的恶心、呕吐、腹痛、腹胀的发生率显著低于C组(P<0.05),服药完成度显著高于C组[(75%)、(67%)VS (58%),(P<0.05)],差异有统计学意义。结论 580μg利那洛肽联合分次剂量2L PEG方案可达到与3L PEG相当的清洁效果,在回肠末端及右半结肠清洁度方面存在一定的优势,并能降低患者肠道准备过程中的不良反应发生率,提高患者进行肠道清洁准备的依从性,可作为肠道准备推荐方案。

Objective To discuss the effect of combined application of compound polyethylene glycol electrolyte and Linalotide on bowel preparation before colonoscopy.Methods A prospective randomized controlled study,A total of 221 patients underwent colonoscopy in the Gastroenterology Department of Xiangyang Central Hospital of Hubei Province from February 2023 to July 2023,and were randomly divided into 3 groups:Group A received 2L PEG,group B received 580 μg linalotide +2 L PEG,and group C(control group) received 3L PEG.PEG were a divided dose regimen.Intestinal cleanliness(BBPS score),lesion detection rate,first defecation interval and total defecation times,incidence of adverse reactions,drug completion degree and other indicators of the three groups were compared.Results The bowel cleansing effect of group B was better than that of group A in the total scores of terminal ileum,right hemicolon,and whole colon [(1.90±0.46) vs(1.64±0.42),(1.84±0.35) vs(1.58±0.46),and(6.70±0.92) vs(6.24±0.98)],and the differences were statistically significant(P<0.05);Group B and Group C,the differences were not statistically significant in different bowel segments and total colon scores(P>0.05).There was no statistically significant difference in the detection rates of polyps,adenomas,and lesions in the terminal ileum among the three groups(P>0.05).The interval between first bowel movements was shorter in Group B than in Groups A and C [(0.98±0.61) h vs.(1.46±1.61) h vs.(1.64±1.89) h,(P<0.05)],and the differences were statistically significant;the total number of bowel movements was higher in Groups B and C than in Groups A group [(10.51±3.28) vs(10.96±3.23) vs(8.65±2.20),(P<0.05)],the difference was statistically significant.The incidence of nausea,vomiting,abdominal pain and bloating was significantly lower in group A and B than in group C.(P< 0.05) Completion of medication intake was significantly higher than in group C [(75%),(67%) vs(58%),(P<0.05)],the difference was statistically significant.Conclusion 580 μg linaclotide combined with split-dose 2L PEG regimen can achieve a cleaning effect comparable to 3L PEG,and there are certain advantages in the end of the ileum and the right hemicolon cleansing,but also reduce the incidence of adverse reactions in the process of intestinal preparation of the patient,improve the patient's adherence to the preparation of intestinal cleansing,which can be used as a recommended regimen for intestinal preparation.