两种肠道清洁剂对便秘患者的肠道准备效果及影响因素分析

目的:分析复方聚乙二醇(Polyethylene Glycol,PEG)电解质散和20%甘露醇对便秘患者肠道准备的效果及影响因素。方法:选取2015年9月~2016年12月结肠镜诊疗前口服肠道清洁剂进行肠道准备的便秘患者544例,按照口服肠道清洁剂的不同分为PEG组239例和20%甘露醇组305例。对两组的肠道准备效果进行分级,并对肠道准备无效的因素进行分析。结果:肠道准备总无效率为22.79%,其中PEG组无效率为24.27%,20%甘露醇组无效率为21.64%,两组的肠道准备效果相比较,差异无统计学意义,P0.05;便秘病程、平时是否服用促动力药或缓泻剂、肠道准备期间活动情况是PEG组肠道准备无效的影响因素;便秘病程是20%甘露醇组肠道准备无效的影响因素。结论:便秘患者在进行肠道准备时,对其进行个体化处理,有助于提高肠道准备的质量和结肠镜诊疗的准确率。     

两种结肠镜检查肠道准备方法的比较

目的比较聚乙二醇电解质散(和爽)与甘露醇对结肠镜检查前肠道清洁效果。方法将120例接受结肠镜检查的患者随机分为观察组和对照组,观察组口服聚乙二醇电解质散(和爽)进行肠道准备,对照组口服20%甘露醇进行肠道准备,以问卷法和观察法收集资料,比较两种方法肠道清洁的效果。结果观察组肠道准备清洁度总体有效率高于对照组,二者差异有统计学意义(P0.05),聚乙二醇电解质散法不良反应轻,两组比较差异有统计学意义(P0.05)。结论聚乙二醇电解质散肠道清洁效果满意,患者不良反应轻,准备时间短,护理方便,更适合门诊患者,是较好的结肠镜检查前肠道准备方法。     

妇科手术前两种肠道准备方法的效果观察

目的探讨两种肠道准备方法在妇科择期手术患者中的应用效果。方法选择121例妇科择期手术患者,随机分为观察组和对照组。观察组62例于手术前1d下午4时开始口服复方聚乙二醇电解质散溶液2000ml,首次口服500ml,以后每15分钟服250ml,直至饮完。对照组59例采用传统的清洁灌肠方法。结果两组患者的肠道清洁度和不良反应比较,经统计学分析,差异有统计学意义（P〈0．05）。结论口服复方聚乙二醇电解质散溶液清洁肠道的方法,简便有效,患者易于接受,切实可行。     

复方聚乙二醇电解质散肠道准备的多因素Logistic回归分析

目的探讨影响复方聚乙二醇电解质散进行肠道准备的相关因素。方法 2016年1至3月收集198例接受结肠镜检查口服3 000 ml复方聚乙二醇电解质散进行肠道准备的患者,采用Boston肠道准备量表对肠道清洁度进行评分。记录患者年龄、性别、体质量指数、糖尿病、腹部手术史、肠镜检查史、便秘、脑卒中、吸烟情况。统计分析时计量资料以均数±标准差表示,组间比较采用独立样本t检验;计数资料以率或构成比表示,组间比较采用χ~2检验及Fisher的精确检验,并使用多因素Logistic回归分析对以上因素进行多因素相关性分析。结果本研究最终纳入198例患者,其中男性110例,女性88例,患者的平均年龄为(55.14±13.04)岁,肠道准备充分率为57.07%(113/198),肠道准备充分与肠道准备不充分两组间小于5 mm息肉发现率及盲肠进入率差异有统计学意义(P=0.00;P=0.00)。多因素Logistic回归分析发现肠镜检查史是影响肠道准备质量的独立危险因素(χ~2=17.13,P=0.00,OR=0.21,95%CI 0.10~0.44),便秘(χ~2=4.24,P=0.04,OR=3.01,95%CI 1.05~8.57)、体质量过重(χ~2=4.30,P=0.04,OR=3.88,95%CI 1.08~13.99)及肥胖(χ~2=4.50,P=0.03,OR=3.88,95%CI 1.12~16.19)是影响肠道准备质量的相对危险因素。而年龄、性别、体质量(消瘦、正常)、糖尿病、腹部手术史、脑卒中、吸烟(以上因素均出现P>0.05)与肠道准备无明显相关性。结论充分的肠道准备可以提高小于5 mm息肉检出率及盲肠进入率。影响肠道准备质量的危险因素有肠镜检查史(独立危险因素)、便秘、体重过重、肥胖。     

服药时间对结肠镜检查肠道准备效果的影响

目的探讨行结肠镜检查时服药时间对肠道准备效果的影响。方法选取行结肠镜检查的200例患者,分为两组,A组:5:00~7:00,B组:10:00~12:00,于肠镜检查前4 h口服复方聚乙二醇电解质散(PGEP)(恒康正清)139.12 g(2 000 ml)作为清肠剂,内镜医师行Boston肠道准备量表(BBPS)和肠腔内气泡评分,记录患者肠道准备时间,问卷调查患者对肠道准备的耐受性,记录肠道准备过程中的不良反应。结果所有患者均完成肠道准备及全结肠镜检查。A组BBPS总分明显高于B组(P0.05),A组肠腔内气泡评分明显低于B组(P0.05),A组肠道准备时间少于B组(P0.05),A组耐受性高于B组(P0.05),A组不良反应明显低于B组(P0.05)。结论 5:00~7:00服用PGEP行结肠镜检查肠道准备时间短、效果好,方便患者就医,能减少患者空腹等待及不适(头晕、饥饿感)等潜在风险,增加其依从性和耐受性,使肠镜检查顺利进行。     

改良肠道准备法在便秘患者肠镜检查中的应用

目的评价改良肠道准备法复方聚乙二醇电解质散(SF-PEG,舒泰清)联合硫酸镁在便秘患者结肠镜检查肠道准备的效果。方法取行结肠镜肠道准备的轻中度便秘患者60例,随机分为两组:A组,常规剂量SF-PEG(438.4 g,4 L),30例;B组,续服贯用SF-PEG(219.2 g,2 L)和硫酸镁(50.00%50 ml,再口服250 ml温开水),30例。Boston肠道准备量表(BBPS)、肠腔内气泡评分和结肠镜检查时间由同一内镜医师单盲记录,药物耐受性、再次肠道准备接受率和不良反应采用患者问卷调查。结果所有患者均完成肠道准备和结肠镜检查。B组结肠镜检查时间短于A组(P0.05);B组BBPS总分高于A组(P0.05);B组肠腔内气泡评分明显低于A组(P0.05);B组再次肠道准备接受率明显高于A组(P0.05)。A、B两组口感和总体不良反应发生情况评分无明显差异(P0.05)。结论应用SF-PEG联合硫酸镁法,对轻中度便秘患者行结肠镜检查,具有耐受性好、清洁度高、镜检效果好和安全可靠等优点,推荐临床应用。     

两种肠道清洁方法在妇科腹腔镜术前准备中的应用效果比较

目的:探讨两种肠道清洁方法在妇科腹腔镜手术前肠道准备中的应用效果。方法:将160例择期手术患者随机分为A、B两组各80例,A组口服番泻叶浸剂,B组口服复方聚乙二醇电解质散溶液,比较两组肠道清洁效果、服药后排便情况及患者不适症状。结果:两组开始排便时间、结束时间及不良反应方面比较差异有统计学意义(P<0.05)。结论:口服复方聚乙二醇电解质散溶液清洁肠道简便、有效、副作用少,患者易于接受。     

揿针在便秘患者结肠镜检查肠道准备中的效果观察

目的探讨揿针联合复方聚乙二醇电解质散(PEG)口服对便秘患者结肠镜检查肠道清洁有效性、耐受性和安全性的影响。方法采用方便抽样法,选取2018年11月-2019年3月在天津市南开医院住院进行结肠镜检查的100例便秘患者,最终纳入96例,随机分为两组,观察组50例患者采用揿针针刺足三里、上巨虚和内关穴联合PEG口服进行肠道准备;对照组46例患者采用常规方法行肠道准备。分别统计两组患者肠道准备评分量表得分、耐受性、服药后不良反应的发生率。结果干预后两组患者肠道清洁度、耐受性和服药后腹胀、恶心等不良反应的发生率均有统计学意义(P0.05),但两组患者服药后腹痛、呕吐、低血糖等不良反应的发生率差异无统计学意义(P0.05)。结论揿针联合PEG口服可提高便秘患者肠道清洁水平和耐受程度,降低服药后腹胀、恶心的发生率,值得临床推广。     

慢性便秘者结肠镜检查前肠道准备的方法

目的比较慢性便秘者结肠镜检查前2种肠道准备方法的效果。方法选择2007年5月-2008年10月在我院行电子结肠镜检查的慢性便秘者60例,随机分为两组,实验组口服番泻叶和复方聚乙二醇电解质散进行肠道准备,对照组单纯口服复方聚乙二醇电解质散。分别观察两组不良反应发生情况和肠道清洁程度。结果两组不良事件发生率比较差异无统计学意义;实验组与对照组的肠道清洁程度比较差异有统计学意义。结论对慢性便秘者应用番泻叶联合复方聚乙二醇电解质散进行肠道准备,其肠道清洁度优于单纯口服复方聚乙二醇电解质散,有利于提高结肠镜检查的成功率。     

两种术前肠道准备方案在肝移植中的应用效果比较

[目的]探讨肝移植术前最佳的肠道准备方案。[方法]将意识清楚,血糖、血钾正常,能耐受口服2 000mL药液,同意参与实验的接受肝移植手术的病人120例,采用随机数字表法分为两组,每组60例。服药组术前采用"口服PEG-ELS全胃肠道灌洗法";灌肠组术前采用"清洁灌肠法"。分别对两组肠道清洁总耗时、护理工作总耗时、病人舒适度、内环境变化、术后胃肠功能恢复情况、术后消化系统并发症的发生率进行观察。[结果]两组病人舒适度、肠道清洁前后血糖、血K+变化,术后首次肛门排气时间的比较、术后消化系统并发症发生率的比较,差异无统计学意义;两组肠道清洁总耗时,灌肠组显著少于服药组(P<0.001);两组护理工作总耗时的比较,服药组显著少于灌肠组(P<0.001)。[结论]肠道清洁是术前肠道准备方案中的一个重要环节,两种肠道准备方案均可达到肝移植术前肠道准备的要求。临床护士应根据手术等待时间,并考虑病人的病情、个人意愿、年龄、民族等因素进行合理选择。     

不同口服肠道准备法对老年便秘患者结肠镜检查的效果

目的探讨用于老年慢性便秘患者安全及有效的肠道准备方法,以提高结肠镜检查的成功率。方法选择2009年7月—2010年7月在上海交通大学附属第六人民医院拟行电子结肠镜检查的老年慢性便秘患者150例,随机分为A组、B组和C组各50例;肠道准备:A组采用复方聚乙二醇电解质散,B组采用番泻叶、甘露醇和口服补液盐,C组采用番泻叶和复方聚乙二醇电解质散。观察并详细记录肠道准备效果,肠镜检查中肠道清洁程度,患者的依从性和不良反应发生情况。结果①C组的肠道清洁度有效率为94.0%,高于A组的66.0%和B组的74.0%;②3组均无严重不良反应发生,C组的不良反应发生率为10.0%,低于A组的26.0%和B组的30.0%。A组与B组在清洁效果与不良反应发生率方面差异均无统计学意义(P>0.05),C组与A组和B组比较,差异有统计学意义(P<0.05)。结论采用口服番泻叶和复方聚乙二醇电解质散应用于老年慢性便秘者的肠道准备效果满意,不良反应小,可提高患者结肠镜检查的成功率,使患者得到及时的诊疗。     

Impact of simethicone on bowel cleansing during colonoscopy in Chinese patients

BACKGROUNDFour-liter polyethylene glycol (PEG) solutions are effective for bowel cleansing, but their large volume might hinder patient compliance. Due to the unique features of Asians, 4 L PEG might be a suboptimal bowel preparation in predominantly ethnically Asian countries. In view of this, a balance should be achieved between the volume and effectiveness. The ideal bowel cleansing regimen for a colonoscopy has yet to be determined in a Chinese population.AIMTo compare the cleansing efficacy of 3 L PEG plus simethicone with 4 L PEG.METHODSA total of 291 patients were randomly allocated to two groups: Group 1 (n = 145) received 4 L split-dose PEG (4-P); group 2 (n = 146) received 3 L split-dose PEG plus simethicone (3-PS). Bowel-cleansing efficacy was evaluated by endoscopists using the Boston bowel preparation scale (BBPS) and the bubbles score.RESULTSAlthough there were no significant differences in the total BBPS score or the adequate rate of bowel preparation between the two groups, the BBPS score of the right-side colon was significantly higher in the 3-SP group (2.37 ± 0.54 vs 2.21 ± 0.78; P = 0.04). Moreover, the use of simethicone significantly reduced bubbles in all colon segments (P < 0.001). The mean withdrawal time was significantly shorter in the 3-PS group (8.8 ± 3.4 vs 9.6 ± 2.3; P = 0.02). Furthermore, significantly more proximal adenomas were detected in the 3-PS group (53.6% vs 45.7%; P = 0.03). In addition, the proportions of patients with nausea and bloating were significantly lower in the 3-SP group (P < 0.01 for both). More patients in the 3-PS group expressed willingness to repeat the bowel preparation (87.7% vs 76.6%, P = 0.01).CONCLUSIONThree-liter PEG shows satisfactory bowel cleansing despite the decrease in dosage, and addition of simethicone with better bubble elimination and enhanced patient acceptance offers excellent potential impact on the detection of proximal adenomas in Chinese patients.     

口服肠道清洁剂联合不同时机灌肠对慢性便秘患者肠道准备效果的影响

目的 探讨口服肠道清洁剂联合不同时机灌肠对慢性便秘患者结肠镜检查前肠道准备效果及安全性的影响。方法 选取2020年10月至2022年9月在苏州市立医院东区消化科接受结肠镜检查的186例慢性便秘患者作为研究对象。按照随机数字表法将其分为对照组（n=62）、观察组Ⅰ（n=62）和观察组Ⅱ（n=62）。对照组于检查日7:00服用2 L复方聚乙二醇电解质散溶液，9:00服用0.9%氯化钠溶液500 mL+温开水500 mL,10:00口服二甲硅油散溶液30 mL；观察组Ⅰ在对照组的基础上，于检查日前1 d 19:00实施清洁灌肠；观察组Ⅱ在对照组的基础上，于检查日10:30予以清洁灌肠。比较3组患者肠道准备合格率、排便总次数、各部分结肠的波士顿肠道准备评分及肠道准备不良反应发生情况。结果 观察组Ⅰ和观察组Ⅱ肠道准备合格率均高于对照组（P<0.05）；观察组Ⅰ排便总次数、右侧结肠波士顿肠道准备评分和全结肠波士顿肠道准备总分明显高于观察组Ⅱ和对照组（P<0.05）。3组患者肠道准备后的恶心、呕吐发生率比较，差异无统计学意义（P>0.05）。观察组Ⅰ和观察组Ⅱ的腹痛和腹胀发生率低于...     

肠内营养乳剂在胃癌患者术前肠道准备中的应用

目的 探讨肠内营养乳剂辅助饮食管理法在胃癌患者术前肠道准备中的应用.方法 选择2012年6-12月入住上海交通大学医学院附属新华医院的胃癌患者80例,随机分为实验组和对照组各40例.术前肠道准备中,实验组采用肠内营养乳剂(瑞代),对照组采用聚乙二醇,评估两组患者术中肠道清洁程度;观察患者肠道准备期间不良反应与术后肠道功能恢复情况.结果 两组患者术中肠道清洁程度比较,差异无统计学意义(P＞0.05);实验组肠道准备期间出现腹胀、恶心和乏力等不良反应的发生率低于对照组;实验组术后肠道功能恢复较早,两组比较差异有统计学意义(P＜0.05).结论 瑞代用于肠道准备能达到良好的肠道清洁要求,且不良反应少,肠道功能恢复时间早,有助于手术患者的早日康复.     

Ascorbic acid and low-volume polyethylene glycol for bowel preparation prior to colonoscopy: A meta-analysis

AIM: To evaluate the benefits of low-volume polyethylene glycol (PEG) with ascorbic acid compared to full-dose PEG for colonoscopy preparation. METHODS: MEDLINE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, CINAHL, PubMed, and recent abstracts from major conferences were searched (January 2012). Only randomized-controlled trials on adult subjects comparing low-volume PEG (2 L) with ascorbic acid vs full-dose PEG (3 or 4 L) were included. Meta-analysis for the efficacy of low-volume PEG with ascorbic acid and full-dose PEG were analyzed by calculating pooled estimates of number of satisfactory bowel preparations as well as adverse patient events (abdominal pain, nausea, vomiting). Separate analyses were performed for each main outcome by using OR with fixed and random effects models. Heterogeneity was assessed by calculating the I² measure of inconsistency. RevMan 5.1 was utilized for statistical analysis. RESULTS: The initial search identified 242 articles and trials. Nine studies (n = 2911) met the inclusion criteria and were analyzed for this meta-analysis with mean age range from 53.0 to 59.6 years. All studies were randomized controlled trials on adult patients comparing large-volume PEG solutions (3 or 4 L) with low-volume PEG solutions and ascorbic acid. No statistically significant difference was noted between low-volume PEG with ascorbic acid and full-dose PEG for number of satisfactory bowel preparations (OR 1.07, 95%CI: 0.86-1.33, P = 0.56). No statistically significant difference was noted between low-volume PEG with ascorbic acid and full-dose PEG for abdominal pain (OR 1.09, 95%CI: 0.81-1.48, P = 0.56), nausea (OR 0.70, 95%CI: 0.49-1.00, P = 0.05), or vomiting (OR 0.99, 95%CI: 0.78-1.26, P = 0.95). No publication bias was noted. CONCLUSION: Low-volume PEG with the addition of ascorbic acid demonstrates no statistically significant difference to full-dose PEG for satisfactory bowel preparation and side-effects.     

慢性便秘患者结肠镜检查前肠道准备不合格的影响因素及护理对策分析

目的:探究慢性便秘患者结肠镜检查前肠道准备不合格的影响因素,提出相关护理对策。方法:采用便利抽样法,选择2018年2月—2020年4月于山西省人民医院消化科行结肠镜检查的146例慢性便秘患者为研究对象,统计其肠道准备不合格情况,利用单因素分析和多因素Logistic回归分析法筛选出肠道准备不合格的影响因素,提出相应护理...     

Efficacy of 1.2L polyethylene glycol plus ascorbic acid for bowel preparations

BACKGROUND A low-volume polyethylene glycol(PEG) solution that combines ascorbic acid with PEG-based electrolyte solution(PEG-ASC) is gaining mainstream acceptance for bowel preparation due to reduced volume and improved taste.Although several reports showed that bowel preparation with PEG-ASC volume lower than 2.0 L with laxative agents could be an alternative to traditional preparation regimen, the cleansing protocols have not been fully investigated.AIM To evaluate the cleansing efficacy of 1.2 L PEG-ASC solution comparing with 2.0 L PEG electrolyte(PEG-ELS) for bowel preparations.METHODS A randomized, single-blinded, open-label, single-center, non-inferiority study was conducted. In total, 312 Japanese adult patients(aged > 18 years) who underwent colonoscopy were enrolled. Patients were randomly allocated to bowel lavage with either 1.2 L of PEG-ASC solution with at least 0.6 L of an additional clear fluid(1.2 L PEG-ASC group) or 2.0 L of PEG-ELS(PEG-ELS group). Then, 48 mg of sennoside was administered at bedtime on the day before colonoscopy, and the designated drug solution was administered at the hospital on the day of colonoscopy. Bowel cleansing was evaluated using the Boston Bowel Preparation Scale(BBPS). The volume of fluid intake and required time for bowel preparation were evaluated. Furthermore, compliance, patient tolerance,and overall acceptability were evaluated using a patient questionnaire, which was assessed using a visual analog scale.RESULTS In total, 291 patients(1.2 L PEG-ASC group, 148; PEG-ELS group, 143) completed the study. There was no significant difference in successful cleansing, defined as a BBPS score ≥ 2 in each segment, between the two groups(1.2 L PEG-ASC group, 91.9%; PEG-ELS group, 90.2%; 95%CI:-0.03-0.09). The required time for bowel preparation was significantly shorter(164.95 min ± 68.95 min vs 202.16 min± 68.69 min, P < 0.001) and the total fluid intake volume was significantly lower(2.23 L ± 0.55 L vs 2.47 L ± 0.56 L, P < 0.001) in the 1.2 L PEG-ASC group than in the PEG-ELS group. Palatability, acceptability of the volume of solution, and overall acceptability evaluated using a patient questionnaire, which was assessed by the visual analog scale, were significantly better in the 1.2 L PEG-ASC group than in the PEG-ELS group(7.70 cm ± 2.57 cm vs 5.80 cm ± 3.24 cm, P < 0.001). No severe adverse event was observed in each group.CONCLUSION The 1.2 L PEG-ASC solution was non-inferior to the 2.0 L PEG-ELS solution in terms of cleansing efficacy and had better acceptability among Japanese patients.     

聚乙二醇电解质溶液在结肠镜检查前肠道准备中的应用与护理

目的研究口服聚乙二醇电解质溶液2 000 ml在肠镜检查前肠道准备中的效果和安全性。方法将100例行结肠镜检查的病人随机分为实验组和对照组,实验组口服聚乙二醇电解质溶液清肠,对照组口服电解质溶液加蓖麻油清肠。观察服药后的排便次数和性状,肠道清洁程度,病人服药后的反应,肠腔内气泡情况。服药前、结肠镜检查结束时分别测心率、血压,进行血、尿常规检查和电解质测定。结果实验组肠道准备时间较对照组明显缩短,两组差异有显著意义;两组清洁肠道有效率均达100%,无明显差异;不良反应实验组明显少于对照组;在耐受性方面,实验组优于对照组。结论口服聚乙二醇电解质溶液清洁肠道效果佳,安全性好,可替代我科传统的电解质溶液加蓖麻油清肠方法。