再次口服缓泻剂与清洁灌肠对普通结肠镜检查肠道准备不充分患者补救效果的对比研究

目的探讨再次口服缓泻剂与清洁灌肠对普通结肠镜检查肠道准备不充分患者的补救效果。方法回顾性分析2018年7月-2019年6月因肠道准备不充分波士顿肠道准备评分(BBPS)总分<6分或3段结肠中任意一段评分<2分]于当天接受补救措施并继续行结肠镜检查的96例患者的临床资料。其中,采取再次口服2 L聚乙二醇电解质散(PEG)溶液(PEG组)59例,接受人工清洁灌肠37例(灌肠组)。比较两组补救处理后的结肠BBPS评分、肠道准备充分率、盲肠插管时间、息肉检出率、不良反应和患者接受度。结果PEG组全结肠(7.9±1.8)和(7.1±1.7)分,t=2.17,P=0.033]、右结肠(2.7±0.8)和(2.2±0.7)分,t=3.12,P=0.002]和横结肠(2.7±0.8)和(2.3±0.7)分,t=2.50,P=0.014]BBPS评分明显高于灌肠组,肠道准备充分率(93.2%和73.0%,χ^2=7.48,P=0.006)明显高于灌肠组,患者接受度(91.5%和75.7%,χ^2=4.59,P=0.032)明显高于灌肠组,差异均有统计学意义(P<0.05)。两组患者左结肠BBPS评分、盲肠插管时间、息肉检出率和不良反应比较,差异均无统计学意义(P>0.05)。结论再次口服2 L PEG溶液对普通结肠镜检查肠道准备不充分的补救效果优于清洁灌肠,且具有较好的可接受度。

Comparative study of the remedial effect of additional oral laxatives and clean enema on patients with inadequate bowel preparation for general colonoscopy*

Objective To investigate the remedial effect of additional oral laxatives and clean enema on patients with inadequate bowel preparation for general colonoscopy.Methods The clinical data of 96 patients from July 2018 to June 2019 with inadequate bowel preparationtotal Boston Bowel Preparation Scale(BBPS)score less than 6 or any of 3 colon segments score less than 2]during an general colonoscopy and received remedial measures on the same day were retrospectively analyzed.Among them,59 patients received additional oral intake of 2 L polyethylene glycol(PEG)electrolyte powder(PEG group)and 37 patients received artificial clean enema(enema group).The BBPS score of colon,adequacy rate of bowel preparation,time of cecum intubation,detection rate of polyps,adverse reactions and patients’acceptance were compared between the two groups.Results The BBPS score of whole colon(7.9±1.8)vs(7.1±1.7)score,t=2.17,P=0.033],right colon(2.7±0.8)vs(2.2±0.7)score,t=3.12,P=0.002]and transverse colon(2.7±0.8)vs(2.3±0.7)score,t=2.50,P=0.014]in PEG group was significantly higher,adequacy rate of bowel preparation(93.2%vs 73.0%,χ^2=7.48,P=0.006)was significantly higher,and patients’acceptance(91.5%vs 75.7%,χ^2=4.59,P=0.032)was significantly higher than those in enema group,with statistical significance(P<0.05).There was no significant difference in BBPS score of left colon,time of cecal intubation,detection rate of polyps and adverse reactions between the two groups.Conclusion Additional oral intake of 2L PEG solution is superior to clean enema in the remedial effect of inadequate bowel preparation for general colonoscopy,and has a better acceptability.