摘要
目的:探讨高剂量(4 L)复方聚乙二醇电解质散(PEG)对便秘患者进行肠道准备的效果、患者的不良反应及耐受情况。方法:根据罗马Ⅳ便秘诊断标准,纳入2020年4月—2021年4月在青岛市第八人民医院行结肠镜检查的便秘患者180例,随机分成A、B、C组,每组60例。A组:于检查前1日晚上8:00服用1 L PEG,当日早上7:00再服用2 L PEG,即3(1+2)L方案;B组:于检查前1日晚上8:00服用2 L PEG,当日早上7:00再服用2 L PEG,即4(2+2)L方案;C组:分别于检查前2日、检查前1日晚上8:00各服用1 L PEG,当日早上7:00再服用2 L PEG,即4(1+1+2)L方案。采用波士顿肠道准备量表(BBPS)评估肠道清洁度,比较各组患者的结肠息肉及小息肉检出率。对每位患者进行问卷调查,记录各组患者的不良反应及耐受情况。结果:A组有3例、B组有2例、C组有2例患者因发现结肠占位,C组有1例患者因无法耐受肠镜而被剔除,最终纳入A组57例、B组58例、C组57例。3组患者在年龄、性别、身体质量指数方面的差异均无统计学意义(P>0.05)。A组患者右半结肠、横结肠、左半结肠BBPS评分及总评分均低于B组、C组,差异有统计学意义(P<0.05);B组、C组患者各肠段BBPS评分及总评分之间的差异无统计学意义(P>0.05)。对于息肉检出率及小息肉检出率,A组患者低于B组、C组,差异有统计学意义(P<0.05);而B组与C组之间的差异无统计学意义(P>0.05)。对于患者的安全性及耐受性,B组患者明显低于A组、C组(P<0.05),A组与C组患者之间的差异无统计学意义(P>0.05)。结论:对于便秘患者,高剂量(4 L)PEG可提高肠道准备的效果,而4(1+1+2)L方案既能提高清肠效果,又具有较高的安全性及耐受性,适合在临床使用。
Objective:To investigate the effectiveness of bowel preparation,the patient tolerance and side effects of high-dose of polyethylene glycol(PEG)electrolyte solution for colonoscopy preparation of constipation patients.Methods:According to the diagnostic criteria of RomanⅣconstipation,180 constipation patients who were to undergo colonoscopy were selected and randomly divided into A,B and C groups,with 60 people in each group.Group A received 1 L of PEG at 20:00 one day before the examination,and 2 L of PEG 6 hours before the examination.Group B received 2 L of PEG at 20:00 one day before the examination,and 2 L of PEG 6 hours before the examination.In group C,1 L of PEG was taken at 20:00 each one and two days before the examination,and 2 L of PEG was taken 6 hours before the examination.Bowel cleanliness was assessed using the Boston Bowel Preparation Scale(BBPS).The rates of colon polyps and small polyps in each group were compared.Patient tolerance to different bowel preparation plans and adverse reactions were obtained through questionnaire survey.Results:Three patients in Group A,two patients in Group B and two patients in Group C were excluded because of mass lesion in the colon of them.One patient in group C terminated colonoscopy due to unable to continue operation during the examination.Finally,there were 57 cases in Group A,58 cases in Group B,and 57 cases in Group C.There was no statistical difference between the three groups in general resource(P>0.05).The efficacy of bowel preparation in Group A was lower than that in Group B and C(P<0.05),and there was no difference among Group B and C(P>0.05).For the rates of colon polyps,Group A was lower than Group B and C(P<0.05),and there was no statistical difference between Group B and C(P>0.05).For the rates of small colon polyps,Group A was lower than Group B and C(P<0.05),and there was no difference between Group B and Group C(P>0.05).For patient tolerance and adverse reactions,Group B was worse than Group A and C(P<0.05),there was no statistical difference between Group A and Group C(P>0.05).Conclusion:For patients with constipation,it is necessary to use high-dose of PEG.The 4(1+1+2)L program not only improves the cleanness of colon but also avoids adverse reactions,and it is worth clinical promotion.
作者
王月盟
杨德玉
赵尚飞
孙学国
WANG Yuemeng;YANG Deyu;ZHAO Shangfei;SUN Xueguo(Department of Gastroenterology,Qingdao Eighth People’s Hospital,Qingdao•Shandong,266041,China;Department of Geriatrics,Qingdao Eighth People’s Hospital;Department of Gastroenterology,the Affiliated Hospital of Qingdao University)
出处
《中国中西医结合消化杂志》
CAS
2022年第5期369-373,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
便秘
高剂量
复方聚乙二醇电解质散
肠道准备
constipation
high-dose
polyethylene glycol electrolyte solution
bowel preparation
