AIM: To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
目的基于“真实世界”研究2 L复方聚乙二醇电解质溶液(PEG)在结肠镜检查前肠道准备时的应用效果。方法选取2022年11月至2023年4月在我院消化内镜中心使用2 L PEG方案进行肠道准备的4268例患者,根据波士顿肠道准备量表(BBPS)对总体、各...目的基于“真实世界”研究2 L复方聚乙二醇电解质溶液(PEG)在结肠镜检查前肠道准备时的应用效果。方法选取2022年11月至2023年4月在我院消化内镜中心使用2 L PEG方案进行肠道准备的4268例患者,根据波士顿肠道准备量表(BBPS)对总体、各段结肠的清洗结果进行评分,按照是否合格分为合格组(n=3802)和不合格组(n=466)。比较两组的危险因素、依从性及患者感受等。结果在使用PEG进行肠道准备的4268例检查者中,3802例合格(合格率89.1%),466例不合格(不合格率10.9%)。BBPS总评分为(6.60±1.10)分,右侧结肠评分为(2.05±0.48)分,横结肠评分为(2.45±0.55)分,左侧结肠为(2.10±0.45)分。息肉总体检出率为51.6%(2203/4268)。进行多因素Logistic回归方程分析,结果显示,男性、胃肠道外科手术史、糖尿病史、每周排便<3次均为导致结肠镜检查前肠道准备不合格的危险因素(均OR>1,P<0.05)。结论2 L PEG方案能够基本满足中国人结肠镜检查肠道准备的需求,对于男性、胃肠道外科手术史、糖尿病史、每周排便<3次的检查者需要进行更严格的肠道准备方式。展开更多
Effective colorectal cancer screening relies on reliable colonoscopy findings which are themselves dependent on adequate bowel cleansing. Research has consistently demonstrated that inadequate bowel preparation advers...Effective colorectal cancer screening relies on reliable colonoscopy findings which are themselves dependent on adequate bowel cleansing. Research has consistently demonstrated that inadequate bowel preparation adversely affects the adenoma detection rate and leads gastroenterologists to recommend earlier follow up than is consistent with published guidelines. Poor preparation affects as many as 30% of colonoscopies and contributes to an increased cost of colonoscopies. Patient tolerability is strongly affected by the preparation chosen and manner in which it is administered. Poor tolerability is,in turn,associated with lower quality bowel preparations. Recently,several new developments in both agents being used for bowel preparation and in the timing of administration have brought endoscopists closer to achieving the goal of effective,reliable,safe,and tolerable regimens. Historically,large volume preparations given in a single dose were administered to patients in order to achieve adequate bowel cleansing. These were poorly tolerated,and the unpleasant taste of and significant side effects produced by these large volume regimens contributed significantly to patients' inability to reliably complete the preparation and to a reluctance to repeat the procedure. Smaller volumes,including preparations that are administered as tablets to be consumed with water,given as split doses have significantly improved both the patient experience and efficacy,and an appreciation of the importance of the preparation to colonoscopy interval have produced additional cleansing.展开更多
AIM:To evaluate the possibility of reducing the volume of polyethylene glycol(PEG)-electrolyte solution using adjunctive mosapride citrate for colonoscopy preparation. METHODS:This was a single-center,prospective, ran...AIM:To evaluate the possibility of reducing the volume of polyethylene glycol(PEG)-electrolyte solution using adjunctive mosapride citrate for colonoscopy preparation. METHODS:This was a single-center,prospective, randomized,investigator-blinded,non-inferiority study involving 252 patients of both sexes,aged from 20 to 80 years,scheduled for screening or diagnostic colonoscopy in our department.A total of 126 patients was randomized to receive 1.5 L PEG-electrolyte solution plus 15 mg of mosapride(1.5 L group),and 126 received 2 L PEG-electrolyte solution plus 15 mg of mosapride(2 L group).Patients completed a questionnaire on the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed using a 5-point scale based on the Aronchick scale.The primary end point was adequate bowel preparation rates(score of excellent/good/fair) vs(poor/inadequate).Acceptability and tolerability,as well as disease detection,were secondary end points. RESULTS:A total of 244 patients was included in the analysis.There were no significant differences between the 2 L and 1.5 L groups in age,sex,body mass index, number of previous colonoscopies,and the preparation method used previously.The adequate bowel preparation rates were 88.5%in the 2 L group and 82.8%in the 1.5 L group[95%lower confidence limit(LCL)for the difference=-14.5%,non-inferiority P=0.019]in the right colon.In the left colon,the adequate bowel preparation rates were 89.3%in the 2 L group and 81.1%in the 1.5 L group(95%LCL=-17.0%,non-inferiority P=0.066).Compliance,defined as complete (100%)intake of the PEG solution,was significantly higher in the 1.5 L group than in the 2 L group(96.8% vs 85.7%,P=0.002).The proportion of abdominal distension(none/mild/moderate/severe)was significantly lower in the 1.5 L group than in the 2 L group (36/65/22/3 vs 58/48/18/2,P=0.040).Within the subgroup who had undergone colonoscopy previously, a significantly higher number of patients in the 1.5 L group than in the 2 L group felt that the current preparation was easier than the previous one(54.1%vs 28.0%,P=0.001).The disease detection rate was not significantly different between the two groups. CONCLUSION:Although the 1.5 L group had better acceptability and tolerability,15 mg of mosapride may be insufficient to compensate for a 0.5-L reduction of PEG solution.展开更多
目的 探讨与标准大容量聚乙二醇电解质散(4L PEG-ELS)方案相比,低容量PEG-ELS联合首荟通便胶囊(SHLC)方案对慢性功能性便秘(CFC)患者结肠镜检查前肠道准备的有效性和安全性。方法 采用单中心、观察者盲法、随机对照试验方法,招募2021年1...目的 探讨与标准大容量聚乙二醇电解质散(4L PEG-ELS)方案相比,低容量PEG-ELS联合首荟通便胶囊(SHLC)方案对慢性功能性便秘(CFC)患者结肠镜检查前肠道准备的有效性和安全性。方法 采用单中心、观察者盲法、随机对照试验方法,招募2021年1月-2021年12月在山东大学齐鲁医院(青岛)接受结肠镜检查的CFC患者282例,随机分配到SHLC+2 L PEG-ELS组、SHLC+3 L PEG-ELS组和4 L PEG-ELS组。观察患者波士顿肠道准备评分(BBPS)和肠道准备耐受性。结果 最终纳入240例患者。SHLC+2 L PEG-ELS、SHLC+3 L PEG-ELS和4 L PEG-ELS组的BBPS分别为(6.22±1.09)、(6.26±0.97)和(7.06±0.63)分,差异无统计学意义(P> 0.05)。节段性BBPS显示,3组患者在左半结肠[(2.32±0.72)、(2.41±0.64)和(2.58±0.59)分]、中段结肠[(2.18±0.83)、(2.26±0.76)和(2.44±0.81)分]和右半结肠[(1.67±0.71)、(1.72±0.67)和(2.23±0.66)分]方面比较,差异均无统计学意义(P> 0.05)。梅奥耐受性问卷显示4 L PEG-ELS组患者耐受性和再次肠道准备意愿均差于SHLC+3 L PEGELS组和SHLC+2 L PEG-ELS组(P=0.007和P=0.021)。与4 L PEG-ELS组相比,SHLC+2 L PEG-ELS组和SHLC+3 L PEG-ELS组服药后首次排便间隔时间提前(P=0.036),睡前排便次数增加(P=0.035),但在总排便次数方面比较,差异无统计学意义(P> 0.05)。3组患者肠道准备后不良反应发生率无明显差异(P> 0.05)。结论 对于CFC患者的肠道准备,低容量PEG-ELS联合SHLC可能是一种新颖的策略,它提高了患者耐受性和依从性,肠道准备效果和安全性与4 L PEG-ELS标准方案相当。展开更多
背景:结肠镜检查是公认的结直肠检查的金标准,而良好的肠道准备是检查成功的前提条件。目的:评价聚乙二醇电解质溶液(PEG-ES)分次与单次口服作为结肠镜检查肠道准备方案的清洁效果和耐受性。方法:连续纳入427例进行结直肠癌筛查的无症...背景:结肠镜检查是公认的结直肠检查的金标准,而良好的肠道准备是检查成功的前提条件。目的:评价聚乙二醇电解质溶液(PEG-ES)分次与单次口服作为结肠镜检查肠道准备方案的清洁效果和耐受性。方法:连续纳入427例进行结直肠癌筛查的无症状个体,随机分为A组和B组。A组于检查前夜和检查前4 h分别口服1.5 L PEG-ES,B组于检查前5 h口服3 L PEG-ES,评估、比较两组Boston肠道准备量表(BBPS)评分、等级和不良反应发生情况。结果:A组与B组间性别、年龄和盲肠插管率差异无统计学意义(P>0.05)。A组BBPS评分显著高于B组(P<0.01);尽管两种方案均能满足常规结肠镜检查的要求,但A组达到excellent肠道清洁等级者的比例显著高于B组(P<0.01),恶心症状发生率显著低于B组(P<0.05)。Logistic回归分析显示PEG-ES服用方式对肠道清洁度和恶心症状的发生有显著影响(P<0.05)。结论:与单次口服相比,分次口服PEG-ES的结肠镜检查肠道准备方案能获得更满意的肠道清洁效果且耐受性良好。展开更多
基金Supported by University of Malaya Research Grant,Project No.RG536-13HTM
文摘AIM: To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
文摘目的基于“真实世界”研究2 L复方聚乙二醇电解质溶液(PEG)在结肠镜检查前肠道准备时的应用效果。方法选取2022年11月至2023年4月在我院消化内镜中心使用2 L PEG方案进行肠道准备的4268例患者,根据波士顿肠道准备量表(BBPS)对总体、各段结肠的清洗结果进行评分,按照是否合格分为合格组(n=3802)和不合格组(n=466)。比较两组的危险因素、依从性及患者感受等。结果在使用PEG进行肠道准备的4268例检查者中,3802例合格(合格率89.1%),466例不合格(不合格率10.9%)。BBPS总评分为(6.60±1.10)分,右侧结肠评分为(2.05±0.48)分,横结肠评分为(2.45±0.55)分,左侧结肠为(2.10±0.45)分。息肉总体检出率为51.6%(2203/4268)。进行多因素Logistic回归方程分析,结果显示,男性、胃肠道外科手术史、糖尿病史、每周排便<3次均为导致结肠镜检查前肠道准备不合格的危险因素(均OR>1,P<0.05)。结论2 L PEG方案能够基本满足中国人结肠镜检查肠道准备的需求,对于男性、胃肠道外科手术史、糖尿病史、每周排便<3次的检查者需要进行更严格的肠道准备方式。
文摘Effective colorectal cancer screening relies on reliable colonoscopy findings which are themselves dependent on adequate bowel cleansing. Research has consistently demonstrated that inadequate bowel preparation adversely affects the adenoma detection rate and leads gastroenterologists to recommend earlier follow up than is consistent with published guidelines. Poor preparation affects as many as 30% of colonoscopies and contributes to an increased cost of colonoscopies. Patient tolerability is strongly affected by the preparation chosen and manner in which it is administered. Poor tolerability is,in turn,associated with lower quality bowel preparations. Recently,several new developments in both agents being used for bowel preparation and in the timing of administration have brought endoscopists closer to achieving the goal of effective,reliable,safe,and tolerable regimens. Historically,large volume preparations given in a single dose were administered to patients in order to achieve adequate bowel cleansing. These were poorly tolerated,and the unpleasant taste of and significant side effects produced by these large volume regimens contributed significantly to patients' inability to reliably complete the preparation and to a reluctance to repeat the procedure. Smaller volumes,including preparations that are administered as tablets to be consumed with water,given as split doses have significantly improved both the patient experience and efficacy,and an appreciation of the importance of the preparation to colonoscopy interval have produced additional cleansing.
文摘AIM:To evaluate the possibility of reducing the volume of polyethylene glycol(PEG)-electrolyte solution using adjunctive mosapride citrate for colonoscopy preparation. METHODS:This was a single-center,prospective, randomized,investigator-blinded,non-inferiority study involving 252 patients of both sexes,aged from 20 to 80 years,scheduled for screening or diagnostic colonoscopy in our department.A total of 126 patients was randomized to receive 1.5 L PEG-electrolyte solution plus 15 mg of mosapride(1.5 L group),and 126 received 2 L PEG-electrolyte solution plus 15 mg of mosapride(2 L group).Patients completed a questionnaire on the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed using a 5-point scale based on the Aronchick scale.The primary end point was adequate bowel preparation rates(score of excellent/good/fair) vs(poor/inadequate).Acceptability and tolerability,as well as disease detection,were secondary end points. RESULTS:A total of 244 patients was included in the analysis.There were no significant differences between the 2 L and 1.5 L groups in age,sex,body mass index, number of previous colonoscopies,and the preparation method used previously.The adequate bowel preparation rates were 88.5%in the 2 L group and 82.8%in the 1.5 L group[95%lower confidence limit(LCL)for the difference=-14.5%,non-inferiority P=0.019]in the right colon.In the left colon,the adequate bowel preparation rates were 89.3%in the 2 L group and 81.1%in the 1.5 L group(95%LCL=-17.0%,non-inferiority P=0.066).Compliance,defined as complete (100%)intake of the PEG solution,was significantly higher in the 1.5 L group than in the 2 L group(96.8% vs 85.7%,P=0.002).The proportion of abdominal distension(none/mild/moderate/severe)was significantly lower in the 1.5 L group than in the 2 L group (36/65/22/3 vs 58/48/18/2,P=0.040).Within the subgroup who had undergone colonoscopy previously, a significantly higher number of patients in the 1.5 L group than in the 2 L group felt that the current preparation was easier than the previous one(54.1%vs 28.0%,P=0.001).The disease detection rate was not significantly different between the two groups. CONCLUSION:Although the 1.5 L group had better acceptability and tolerability,15 mg of mosapride may be insufficient to compensate for a 0.5-L reduction of PEG solution.
文摘目的 探讨与标准大容量聚乙二醇电解质散(4L PEG-ELS)方案相比,低容量PEG-ELS联合首荟通便胶囊(SHLC)方案对慢性功能性便秘(CFC)患者结肠镜检查前肠道准备的有效性和安全性。方法 采用单中心、观察者盲法、随机对照试验方法,招募2021年1月-2021年12月在山东大学齐鲁医院(青岛)接受结肠镜检查的CFC患者282例,随机分配到SHLC+2 L PEG-ELS组、SHLC+3 L PEG-ELS组和4 L PEG-ELS组。观察患者波士顿肠道准备评分(BBPS)和肠道准备耐受性。结果 最终纳入240例患者。SHLC+2 L PEG-ELS、SHLC+3 L PEG-ELS和4 L PEG-ELS组的BBPS分别为(6.22±1.09)、(6.26±0.97)和(7.06±0.63)分,差异无统计学意义(P> 0.05)。节段性BBPS显示,3组患者在左半结肠[(2.32±0.72)、(2.41±0.64)和(2.58±0.59)分]、中段结肠[(2.18±0.83)、(2.26±0.76)和(2.44±0.81)分]和右半结肠[(1.67±0.71)、(1.72±0.67)和(2.23±0.66)分]方面比较,差异均无统计学意义(P> 0.05)。梅奥耐受性问卷显示4 L PEG-ELS组患者耐受性和再次肠道准备意愿均差于SHLC+3 L PEGELS组和SHLC+2 L PEG-ELS组(P=0.007和P=0.021)。与4 L PEG-ELS组相比,SHLC+2 L PEG-ELS组和SHLC+3 L PEG-ELS组服药后首次排便间隔时间提前(P=0.036),睡前排便次数增加(P=0.035),但在总排便次数方面比较,差异无统计学意义(P> 0.05)。3组患者肠道准备后不良反应发生率无明显差异(P> 0.05)。结论 对于CFC患者的肠道准备,低容量PEG-ELS联合SHLC可能是一种新颖的策略,它提高了患者耐受性和依从性,肠道准备效果和安全性与4 L PEG-ELS标准方案相当。
文摘背景:结肠镜检查是公认的结直肠检查的金标准,而良好的肠道准备是检查成功的前提条件。目的:评价聚乙二醇电解质溶液(PEG-ES)分次与单次口服作为结肠镜检查肠道准备方案的清洁效果和耐受性。方法:连续纳入427例进行结直肠癌筛查的无症状个体,随机分为A组和B组。A组于检查前夜和检查前4 h分别口服1.5 L PEG-ES,B组于检查前5 h口服3 L PEG-ES,评估、比较两组Boston肠道准备量表(BBPS)评分、等级和不良反应发生情况。结果:A组与B组间性别、年龄和盲肠插管率差异无统计学意义(P>0.05)。A组BBPS评分显著高于B组(P<0.01);尽管两种方案均能满足常规结肠镜检查的要求,但A组达到excellent肠道清洁等级者的比例显著高于B组(P<0.01),恶心症状发生率显著低于B组(P<0.05)。Logistic回归分析显示PEG-ES服用方式对肠道清洁度和恶心症状的发生有显著影响(P<0.05)。结论:与单次口服相比,分次口服PEG-ES的结肠镜检查肠道准备方案能获得更满意的肠道清洁效果且耐受性良好。
