早晨服用复方聚乙二醇电解质散行肠道准备的效果

目的比较肠镜检查当天早晨服用复方聚乙二醇电解质散(polyethylene glycol electrolytes powder,PGEP)与传统的前一天晚上服用同量PGEP行肠道准备的效果。方法采用随机、单盲、前瞻性研究方法,将杭州市第一人民医院门诊需要肠镜检查的患者随机分为两组,一组为早晨组:在检查当天早晨6～10点开始服用PGEP行肠道准备,另一组为晚上组:在检查前一天晚上即开始服用PGEP。内镜医生按照Ottawa量表对肠道准备的效果进行评分,先对每一段肠管进行评分,再将得分综合。同时每位患者填写一份满意度调查表,内容包括服用泻剂剂量、因肠道准备损失的睡眠时间、限制饮食的难易度、不良反应等。结果共纳入318位患者,随机分为两组进行了研究。早晨组患者的Ottawa评分低于晚上组,并且在几乎每一个肠段的准备效果都优于晚上组(P<0.01),在息肉,尤其小息肉(<5mm)的检出率方面也明显高于晚上组(P<0.01),尽管两组间息肉阳性患者数量无明显差异。此外,早晨组患者出现失眠概率比晚上组低(P<0.01)。结论结肠镜检查当日早晨口服PGEP行肠道准备优于传统的前一天晚上开始准备肠道,不但可以提高结肠镜检查的质量,而且可提高结肠息肉的检出率。

Morning-only Polyethylene Glycol Electrolytes Powder Improves Bowel Cleansing for Afternoon Colonoscopies

Objective To compare the efficacy of bowel cleansing achieved by administering polyethylene glycol electrolytes powder(PGEP) preparation to patients in the morning for an afternoon colonoscopy with that of the traditional evening regimen.Methods A prospective endoscopist-blinded study was conducted,in which patients undergoing afternoon colonoscopy were randomized to receive either PGEP the evening before the procedure or the morning of the colonoscopy.Bowel cleansing efficacy was scored by a blinded endoscopist using the Ottawa scale and each participant filled out a satisfaction survey.Mean scores for each bowel segment,composite mean scores,and rates of "good prep" interpreted from the Ottawa scale were compared between the two groups.Results A total of 318 patients evenly distributed between the two groups formed the study sample.Patients in the morning group had significantly lower Ottawa scale scores and were more likely to have a good preparation for each bowel segment and overall when compared with the evening group(P<0.01),and overall polyp detection rate in morning group was much higher than the evening group,although there was no difference in number of patients with adenomas.Moreover,patients in the morning group were less likely to lose sleep compared with the evening group(P<0.05).Conclusion This study shows that the bowel cleansing efficacy of morning-only 3L PGEP is superior and better tolerated compared with consumption of 3L PGEP in the evening before the day of an afternoon colonoscopy.Thus,administering 3L PGEP solution in the morning of an afternoon colonoscopy is a feasible option that can improve the quality of an afternoon colonoscopy.