乳果糖和聚乙二醇电解质散联合应用在结肠镜检查前肠道准备中的价值

[目的]对比分析乳果糖口服液联合聚乙二醇电解质散Ⅰ或Ⅳ与单用聚乙二醇电解质散Ⅰ或Ⅳ进行肠道准备的效果差异。[方法]采用随机对照方式,将300例拟行结肠镜检查者分为以下4组,试验①组74例(服用乳果糖口服液和聚乙二醇电解质散Ⅰ)和对照①组75例(单纯服用聚乙二醇电解质散Ⅰ),以及试验②组75例(服用乳果糖口服液和聚乙二醇电解质散Ⅳ)和对照②组76例(单纯服用聚乙二醇电解质散Ⅳ)。[结果]经波士顿肠道准备评分量表评分,试验①组、对照①组分别为(7.14±0.68)分、(6.21±1.13)分,2组比较差异有统计学意义(P=0.000);试验②组、对照②组分别为(7.05±0.78)分、(6.13±1.06)分,2组比较差异亦有统计学意义(P=0.000)。到达回盲部所用时间,试验①组为(8.50±1.74)min,对照①组为(9.42±1.90)min,2组间差异无统计学意义(P=0.223);试验②组为(8.70±1.63)min,对照②组为(9.31±1.58)min,2组间差异亦无统计学意义(P=0.241)。大肠息肉检出率:试验①组22.97%,对照①组18.67%,2组比较差异无统计学意义P=0.255);但试验①组息肉直径≤0.5 cm者检出率显著高于对照①组(P=0.032);大肠息肉检出率:试验②组25.33%,对照②组19.74%,2组比较差异无统计学意义(P=0.286);但试验②组息肉直径≤0.5 cm者检出率显著高于对照②组(P=0.037)。试验组与对照组的不良反应比较差异亦无统计学意义。[结论]在结肠镜检查前的肠道准备中,联用乳果糖口服液和聚乙二醇电解质散比单用聚乙二醇电解质,可以明显改善患者的肠道准备效果,提高小息肉的检出率,且安全性好、经济实用。     

乳果糖在结肠镜检查前肠道准备的应用及研究进展

乳果糖在国内外常用作肠道准备药物,但目前尚缺乏关于此方面的系统综述。本文将就乳果糖在结肠镜检查前肠道准备的应用情况与研究现状作一综述,以期为临床工作提供一定参考。     

低剂量聚乙二醇联合硫酸镁用于肠道准备的效果评价

背景：聚乙二醇（PEG）为临床常用肠道准备清洁剂,但仍存在一些缺点。笔者等设计了一种低剂量PEG联合低剂量硫酸镁的肠道准备方案,以期能减少PEG溶液摄入量,提高肠腔清洁程度,减少气泡,缩短结肠镜检查时间。目的：以标准剂量PEG方案为对照,评价新方案在结肠镜检查前肠道准备中的有效性、耐受性、安全性以及合适的给药时机。方法：连续收集拟行结肠镜检查者180例,随机分为三组。A组服用标准剂量PEG（68.56 g/包×2包）、B组连续服用低剂量PEG（1包）和硫酸镁（25%,60 ml）、C组间断服用低剂量PEG和硫酸镁行肠道准备。内镜医师单盲行Boston肠道准备量表（BBPS）和肠腔内气泡评分,记录结肠镜检查时间。问卷调查患者对药物的耐受性,记录服药后不良反应。监测用药前后心率、血压和实验室指标。结果：所有患者均完成肠道准备和全结肠镜检查。B、C两组BBPS总分显著高于A组（P〈0.05）,结肠镜检查时间显著短于A组（P〈0.05）,B组肠腔内气泡评分显著低于A、C两组（P〈0.05）。B、C两组药物口感评分、完全服用率和愿意再服率均高于A组。三组间总体不良反应评分无明显差异。结论：与标准剂量PEG方案相比,连续服用低剂量PEG和低剂量硫酸镁用于结肠镜检查前肠道准备更为有效,耐受性更高;两种方案安全性相似。     

清肠操联合乳果糖在肠道准备中的应用效果研究

目的 探讨肠道准备操(清肠操)联合乳果糖口服液在患者结肠镜检查前肠道准备中的应用效果.方法 按照患者结肠镜检查顺序将患者分为五个组,A组:聚乙二醇电解质散(PEG)3000 mL+温水1000 mL;B组:清肠操+PEG 3000 mL+温水1000 mL,10 min做一组,每小时做3组;C组:乳果糖口服溶液15 m...     

肠道准备场所对各年龄层患者肠道准备效果的影响

[目的]研究住院及门诊两种场所对各年龄层患者肠道准备效果的影响.[方法回顾性分析住院及门诊行结肠镜检查的患者共158例,评估各患者肠道准备情况,比较各年龄层段,门诊及住院患者肠道准备清洁度的差异.[结果]年龄对患者肠道准备效果无统计学差异.门诊组患者的肠道准备合格率明显高于住院组(85.19％∶66.23％,P＜0.0...     

复方聚乙二醇电解质散联合乳果糖在老年便秘病人肠道准备中的效果评价

肠镜检查是临床诊断结直肠疾病的金标准,但如果肠镜检查前肠道准备不充分,肠腔内的粪便会掩盖黏膜病变,对内镜的观察造成影响,极大程度上增加内镜检查漏诊、失败的可能[1]。     

不同剂量西甲硅油对结肠镜检查肠道准备效果的影响

目的 探讨不同剂量西甲硅油对结肠镜检查肠道准备效果的影响.方法 将320例行普通结肠镜检查的门诊患者随机分为A、B、C、D4组,每组各80例.A组单纯服用复方聚乙二醇电解质散进行肠道准备,B、C、D组患者在A组的基础上再分别服用10 ml、15 ml、30 ml西甲硅油进行肠道准备.比较4组患者的一般资料、肠道清洁满意...     

利那洛肽联合复方聚乙二醇在结肠镜肠道准备中应用的初步研究

目的　初步探索利那洛肽联合复方聚乙二醇（polyethylene glycol，PEG）在结肠镜肠道准备中的作用。方法　本试验是一项多中心随机对照研究。连续纳入2021年11月—2022年3月在上海长海医院、山西省人民医院和联勤保障部队第九〇〇医院3家消化内镜中心接受结肠镜检查的受试者，采用完全随机法分成3组，A组肠道准备方案为3 d利那洛肽+3 L PEG，B组为仅3 L PEG，C组为3 d利那洛肽+2 L PEG。主要观察指标为肠道准备合格率，次要观察指标包括肠道准备优秀率、肠道准备完成率以及肠道准备愿意重复率。结果　共入组130例受试者，其中A组46例，B组43例，C组41例，3组受试者肠道准备合格率［95.7%（44/46）、93.0%（40/43）和95.1%（39/41），χ2=0.465，P=0.893］，肠道准备优秀率［43.5%（20/46）、25.6%（11/43）和34.1%（14/41），χ2=3.151，P=0.207］及肠道准备完成率［95.7%（44/46）、95.3%（41/43）和100.0%（41/41），χ2=1.909，P=0.544］差异均无统计学意义。3组受试者愿意再次行相应肠道准备方案的愿意重复率差异有统计学意义［89.1%（41/46）、74.4%（32/43）和100.0%（41/41），χ2=12.862，P=0.002］。C组受试者肠道准备完成率和愿意重复率均为100.0%，较A、B两组有升高趋势。结论　利那洛肽有提高肠道准备质量的趋势，可以减少PEG用量。     

匹维溴铵联合乳果糖在肠道准备中的应用

[目的]探究匹维溴铵联合乳果糖在肠道准备中的应用效果。[方法]选取2017年11月~2019年4月在上海市普陀区利群医院行结直肠镜检查患者90例,随机分为3组:乳果糖组、匹维溴铵组和联合组(乳果糖+匹维溴铵),对比3组检查耐受度、腹痛程度、肠道清洁度、炎症反应指标及不良反应情况。[结果]联合组患者检查耐受度显著高于乳果糖组与匹维溴铵组(P<0.05);联合组患者肠道清洁符合率显著高于乳果糖组与匹维溴铵组(P<0.05);联合组NRS疼痛评分、检查时间与肠鸣音恢复时间均显著低于乳果糖组与匹维溴铵组(P<0.05);检查后联合组患者心率低于乳果糖组与匹维溴铵组(P<0.05),检查后3组患者血压比较差异无统计学意义;3组患者总不良反应发生率比较差异无统计学意义。[结论]匹维溴铵联合乳果糖用于肠道准备,能够提高患者检查耐受度与肠道清洁度,减轻腹痛,且不良反应较少,可有效缩短检查时间。     

早期口服乳果糖应用于糖尿病患者肠道准备中的效果分析

目的 探讨早期口服乳果糖应用于糖尿病患者肠道准备中的效果.方法 选取该院2018年9月—2020年2月收治的83例糖尿病患者作为研究对象,按照简单随机化法分为对照组(n=41,予以常规准备)和观察组(n=42,在对照组的基础上检查前口服乳果糖),观察两组患者治疗效果、肠道耐受度、肠道准备情况及不良反应的发生.结果 治疗...     

Colonic lavage with two polyethylene glycol solutions prior to colonoscopy makes no difference: A prospective randomized controlled trial

Objective. It is suggested that bowel preparations for colonoscopy are easier to tolerate when a smaller volume of solution with a more pleasant taste is used. The aim of this study was to establish equivalence between a 3-l sulphate-free polyethylene glycol solution (SF-PEG) and a 4-l PEG solution in effectiveness, patients’ acceptability and tolerability. Material and methods. The study comprised 110 patients scheduled for elective colonoscopy and randomized to receive either SF-PEG or PEG. Before colonoscopy, the patients completed a questionnaire on stool frequency, medication, concomitant diseases, the amount of solution ingested, willingness to retake it, volume of other fluid taken and tolerance of bowel preparation, taste of the laxative and occurrence of abdominal cramps. Three experienced endoscopists, blinded to the type of preparation, assigned bowel-cleansing scores using a validated 5-point scale to assess cleansing effect. Results. Data were available for 102 patients (44 M (40%), mean age 53 years, range 23–83 years). No significant differences were found in cleansing the rectosigmoid (p=0.71) or complete colon (p=0.79). Diverticulosis, constipation, gender and body mass index (BMI) did not influence cleansing. There was no significant difference in compliance between the two groups (p=0.61). No differences were found for tolerance, taste and abdominal cramps. Patients who received SF-PEG had a preference for the same preparation next time in comparison with patients who had PEG cleansing (17 (33%) versus 4 (8%), respectively) (p=0.03). Conclusions. Both preparations are comparable in their cleansing effect and toleration. However, patients prefer cleansing with a smaller volume of solution. Improving the acceptability of colonic preparation could improve willingness to undergo colonoscopies in the future.     

Efficacy of prepackaged, low residual test meals with 4L polyethylene glycol versus a clear liquid diet with 4L polyethylene glycol bowel preparation: A randomized trial

Background and study aims:  A prepackaged low residue one-day diet (breakfast, lunch and dinner) has been recently developed to improve patient tolerance for bowel preparation prior to colonoscopy. The aims of this study were to evaluate the efficacy and tolerability of bowel preparation protocols based on a low residue diet and 4L polyethylene glycol (PEG) solution, and to compare these new options with the traditional liquid diet and the PEG 4L lavage.
Methods:  A total of 214 patients (mean age: 54.1 years; 120 male, 94 female) from four university hospitals were included in the analysis. Patients were randomized to receive a clear liquid diet and the PEG 4L regimen (106 patients) or the low residue test meals and the PEG 4L regimen (TM-PEG 4L, 108 patients). The colon cleansing efficacy of the different preparations was rated using the Ottawa bowel preparation scale.
Results:  No significant differences were observed between the treatment groups according to the Ottawa cleansing scale findings (PEG 4L: 2.97 vs TM-PEG 4L: 2.46, P  = 0.063). The overall tolerability was higher in the TM-PEG 4L group than in the PEG 4L group ( P  = 0.036). No difference was found when the two groups were compared with regard to adverse events ( P  = 0.599).
Conclusions:  A prepackaged low residue one-day diet provided cleansing efficacy similar to that of a clear liquid diet and offered the benefit of improved tolerability compared to the conventional PEG 4L regimen.     

Bowel preparation for colonoscopy: A randomized prospective trial comparing sodium phosphate and polyethylene glycol in a predominantly elderly population

Many patients find polyethylene glycol-based preparations (PEG) difficult to take because of the large volume of fluid they are required to consume. One hundred and sixteen predominantly elderly patients were randomized to receive either sodium phosphate (n= 61) or PEG (n= 55) bowel preparations before colonoscopy. Patients with a history of symptomatic ischaemic heart disease or cerebrovascular disease in the preceding 6 months, severe liver disease or heart failure, or serum creatinine above 200 μg/L were excluded from the study. Each patient filled in a questionnaire about the bowel preparation prior to the procedure. The colonoscopists, who were not aware which preparation had been used, were asked to complete a questionnaire about the quality of the bowel preparation after the procedure. The patients found the sodium phosphate preparation slightly more tolerable than PEG. Side effects were slightly more common with sodium phosphate. Neither difference was statistically significant. However, 91% of patients who had previously had PEG found sodium phosphate easier to take. Approximately 25% of patients in each group experienced at least one episode of incontinence. The colonoscopists found no difference in the overall quality of the bowel preparation. The amount of fluid in the colon was greater in patients prepared with PEG. As expected, patients taking sodium phosphate developed hyperphosphataemia (mean phosphate level before colonoscopy 1.56 mmol/L, normal 0.8–1.3). They also had a lower mean serum potassium level (3.8 mmol/L) than the PEG group (4.2 mmol/L). However, there were no clinically significant consequences. Sodium phosphate was a safe and effective bowel preparation for colonoscopy in this carefully selected group of patients. It was preferred by patients who had previously had PEG. Many elderly patients were found to develop faecal incontinence, irrespective of the type of bowel preparation used.     

利那洛肽联合复方聚乙二醇电解质散用于结肠镜肠道准备的临床研究

目的探讨利那洛肽联合复方聚乙二醇电解质散(polyethylene glycol electrolytes powder, PEG)作为结肠镜肠道准备方案的价值。方法采用随机、单盲的前瞻性临床研究, 纳入2021年6—8月于南方医科大学深圳医院消化内科门诊行结肠镜检查的患者。将行结肠镜肠道准备的患者分成2组, 试验组152例患者采用580 μg利那洛肽+2 L PEG方案, 对照组152例患者采用3 L PEG方案。比较两组患者肠道准备效果(波士顿肠道准备量表评分、气泡评分和病变检出率)及安全性(不良事件)。结果试验组与对照组相比, 波士顿肠道准备量表评分[总评分9(8, 9)分比9(9, 9)分, Z=0.141, P=0.888], 气泡评分[1(1, 2)分比1(1, 1)分, Z=1.788, P=0.074]及总体病变检出率[37.50%(57/152)比33.55%(51/152), χ2=0.517, P=0.472]差异均无统计学意义。在安全性方面, 试验组与对照组相比, 恶心[7.24%(11/152)比13.16%(20/152), χ2=2.910, P=0.08...     

Electrolyte changes after bowel preparation for colonoscopy:A randomized controlled multicenter trial

AIM:To investigate the electrolyte changes between 2-L polyethylene glycol with ascorbic acid 20 g(PEGAsc) and 4-L PEG solutions.METHODS:From August 2012 to February 2013,a total of 226 patients were enrolled at four tertiary hospitals.All patients were randomly allocated to a PEG-Asc group or a 4-L PEG.Before colonoscopy,patients completed a questionnaire to assess bowel preparation-related symptoms,satisfaction,and willingness.Endoscopists assessed the bowel preparation using the Boston Bowel Preparation Scale(BBPS).In addition,blood tests,including serum electrolytes,serum osmolarity,and urine osmolarity were evaluated both before and after the procedure.RESULTS:A total of 226 patients were analyzed.BBPS scores were similar and the adequate bowel preparation rate(BBPS≥6)was not different between the two groups(PEG-Asc vs 4-L PEG,73.2%vs 76.3%,P=0.760).Bowel preparation-related symptoms also were not different between the two groups.The taste of PEG-Asc was better(41.1%vs 16.7%,P0.001),and the willingness to undergo repeated bowel preparation was higher in the PEG-Asc group(73.2%vs 59.3%,P=0.027)than in 4-L PEG.There were no significant changes in serum electrolytes in either group.CONCLUSION:In this multicenter trial,bowel preparation with PEG-Asc was better than 4-L PEG in terms of patient satisfaction,with similar degrees of bowel preparation and electrolyte changes.     

Randomized controlled trial of sodium phosphate tablets vs polyethylene glycol solution for colonoscopy bowel cleansing

AIM: To compare efficacy, patient compliance, acceptability, satisfaction, safety, and adenoma detection rate of sodium phosphate tablets (NaP, CLICOLON^TM) to a standard 4 L polyethylene glycol (PEG) solution for bowel cleansing for adults undergoing colonoscopy.METHODS: In this multicenter, randomized, prospective, investigator-blind study, the relatively young (19-60 years) healthy outpatients without comorbidity were randomly assigned to one of two arms. All colonoscopy were scheduled in the morning. The NaP group was asked to take 4 tablets, 5 times the evening before and 4 tablets, 3 times early on the morning of the colonoscopy. The PEG group was asked to ingest 2 L of solution the evening before and 2 L early in the morning of the procedure. Adequacy of bowel preparation was scored using the Boston bowel preparation scale.RESULTS: No significant differences were observed between the NaP group (n = 158) and PEG group (n = 162) in bowel cleansing quality (adequate preparation 93.0% vs 92.6%, P = 0.877), patient compliance (P = 0.228), overall adverse events (63.3% vs 69.1%, P = 0.269), or adenoma detection rate (34.8% vs 35.2%, P = 0.944). Patient acceptability, satisfaction, and patient rating of taste were higher in the NaP group than in the PEG group (P < 0.001).CONCLUSION: NaP tablets, compared with PEG solution, produced equivalent colon cleansing, did not cause more side effects, and had better patient acceptability and satisfaction in the relatively young (age < 60 years) healthy individuals without comorbidity. An oral tablet formulation could make bowel preparation less burdensome, resulting in greater patient participation in screening programs.     

硫酸镁溶液联合复方聚乙二醇电解质散在胶囊内镜检查前肠道准备中的价值

目的 探讨硫酸镁联合复方聚乙二醇电解质散在胶囊内镜检查术前肠道准备中的应用价值.方法 81例患者分成单纯口服复方聚乙二醇电解质散组(A组,n =41)和硫酸镁联合复方聚乙二醇电解质散口服组(B组,n =40),比较两组病变检出情况、肠道准备评分结果、胶囊滞留发生情况及电解质、肝肾功能检测结果.结果 A组病变检出率为65.9％( 27/41),B组为62.5％(25/40),差异无统计学意义(x2=0.099,P＞0.05);A组肠道准备评分≤4分19例、≥6分22例,B组≤4分28例、≥6分12例,差异有统计学意义(x2=4.653,P＜0.05);A组胶囊滞留发生率为2.4％(1/41),B组为5.0％ (2/40),差异无统计学意义(x2=0.372,P＞0.05).两组患者服用肠道准备药物过程中均无明显腹痛、恶心、呕吐、心慌等不适,服药后两组电解质水平及肝肾功能指标值比较差异均无统计学意义(P＞0.05).结论 硫酸镁联合复方聚乙二醇电解质散应用于胶囊内镜检查术前肠道准备具有较好的应用价值.