单倍剂量磷酸钠盐口服溶液联合西甲硅油乳剂在结肠镜检查肠道准备中的应用

背景:良好的肠道准备是结肠镜检查和治疗的必要前提。双倍剂量(45 mL x2)磷酸钠盐口服溶液用于肠道准备清洁效果良好,但易产生气泡而影响观察。目的:评价单倍剂量(45 mL)磷酸钠盐口服溶液联合消泡剂西甲硅油乳剂用于结肠镜检查肠道准备的效果。方法:纳入疑有结直肠病变而拟接受结肠镜检查且符合纳入和排除标准者110例,随机分为试验组和对照组。试验组检查当日晨服用磷酸钠盐口服溶液45 mL+温开水750 mL,1 h后口服西甲硅油乳剂30 mL;对照组服用磷酸钠盐口服溶液90 mL+温开水1500 mL。比较两组肠道清洁效果、祛泡效果、术后腹胀程度、结肠镜检查时间等指标。结果:试验组肠道清洁效果与对照组相似(A、B级:89.1%对80.0%,P>0.05),祛泡效果显著优于对照组(A、B级:83.6%对56.4%,P<0.05),术后腹胀程度显著轻于对照组(无或轻度腹胀:89.1%对70.9%,P<0.05),结肠镜检查时间较对照组显著缩短(7.1±3.2)min对(9.2±3.7)min,P<0·05]。结论:单倍剂量磷酸钠盐口服溶液联合西甲硅油乳剂用于结肠镜检查的肠道准备效果良好,安全性和耐受性高,值得推荐应用于临床。

Application of Single Dose Sodium Phosphates Oral Solution Combined with Simethicone Emulsion in Bowel Preparation for Colonoscopy

Adequate bowel preparation is essential for colonoscopic procedures. Double dose （45 mL× 2） sodium phosphates （NaP） oral solution has been demonstrated to be effective for colonic cleansing, however, air bubbles are easily produced and may interfere the endoscopic observation. Aims： To assess the efficacy of single dose （45 mL） NaP oral solution combined with an antifoaming agent, simethicone emulsion in bowel preparation for colonoscopy. Methods： One hundred and ten patients suspected of colorectal diseases and referring for colonoscopy were recruited and randomly divided into study group and control group. All patients fulfilled the inclusion and exclusion criteria. Patients in study group received 30 mL simethicone emulsion orally 1 hour after drinking 45 mL NaP oral solution diluted in 750 mL boiled water, while patients in control group drank 90 mL NaP oral solution diluted in 1500 mL boiled water only. The bowel cleanness, air bubbles in bowel lumen, postprocedure abdominal distention and operating time of colonoscopy were compared between the two groups. Results ： The efficacy of bowel cleanness in study group was comparable to that in control group （ Grade A and B ： 89.1% vs. 80.0% , P 〉 0.05） , while the air bubbles in bowel lumen was significantly less in study group than in control group （Grade A and B： 83.6% vs. 56.4% , P 〈 0.05）. In addition, the postprocedure abdominal distention was less and the operating time of colonoseopy was shortened in study group when compared with control group none/mild abdominal distention： 89.1% vs. 70.9%, P〈0.05; operating time： （7. 1 ±3.2） min vs. （9.2±3.7） min, P〈 O. 05 ]. Conclusions： Single dose NaP oral solution combined with simethicone emulsion is safe, effective and well tolerated in bowel preparation for colonoscopy, and is worthy to be recommended in clinical practice.