大肠水疗联合聚乙二醇对便秘患者肠道准备效果的研究

目的 比较不同顺序下使用大肠水疗和聚乙二醇对便秘患者结肠镜检查前肠道准备效果的差异。方法 选择2019年4月至2019年9月，在杭州市第三人民医院内镜中心接受结肠镜检查的122例便秘患者为研究对象，按交替随机法1：1比例分为研究组和对照组。研究组按大肠水疗——口服聚乙二醇顺序进行肠道准备，对照组按口服聚乙二醇——大肠水疗顺序进行肠道准备。比较两组肠道准备合格率、肠道清洁度波士顿量表评分（BBPS）、不良反应发生率、操作时间、结肠镜插入深度、患者可视化疼痛评分（VAS）和息肉检出率。结果 研究组肠道准备合格率为86.9%，对照组为75.4%，两组间差异无统计学意义（P ＞0.05）；研究组BBPS总评分为（6.7±1.0）分，对照组为（6.2±1.1）分，研究组明显高于对照组，两组差异具有统计学意义（P ＜0.05）。研究组右半结肠BBPS评分高于对照组，差异具有统计学意义（P ＜0.05），横结肠和左半结肠BBPS评分与对照组差异均无统计学意义（P ＞0.05）。研究组和对照组不良反应发生率分别为6.6%和4.9%，两组间差异无统计学意义（P ＞0.05）。研究组在操作时间、插镜深度、VAS评分上，均低于对照组，两组之间差异均具有统计学意义（均P ＜0.05）。研究组和对照组息肉检出率分别为19.7%和13.1%，差异无统计学意义（P ＞0.05）。结论 对于拟行结肠镜检查的便秘患者，大肠水疗联合口服聚乙二醇可达到合格的肠道准备效果，先行大肠水疗后口服聚乙二醇的效果更佳。

Effect of Colon Hydrotherapy and Polyethylene Glycol on Bowel Preparation in patients with constipation

Objective To compare the effect of colon hydrotherapy and polyethylene glycol on bowel preparation before colonoscopy in patients with constipation.Method 122patients with constipation who underwent colonoscopy in Endoscopy center of Hangzhou Third People''s Hospital were selected for research from Mar to Sep 2019. Alternating random method was used to devide the patients into the studyand control group according to the ratio of 1:1.The study group received bowel preparation in the order of colon hydrotherapy before polyethylene glycol(PEG), and the control group was on the contrary. The qualified bowel preparation rate, Boston Bowel Preparation Scale(BBPS), adverse reaction rate, operation time, depth of insertion, Visual Pain Score (VAS), and polyp detection rate were compared between the two groups. Results The rate of qualified bowel preparation were 86.9% in the study group and 75.4% in the control group, respectively, the difference between the two groups was not statistically significant (P> 0.05).The total BBPS score of the study group was (6.7±1.0) points, and that of the control group was (6.2±1.1) points. The study group was significantly higher than the control group, and the difference between the two groups was statistically significant (P< 0.05). BBPS scores of the right colon in the study group were higher than the control group, and the difference was statistically significant (P < 0.05), while BBPS scores of the transverse colon and left colon were not statistically significant (P> 0.05). The incidence of adverse reactions in the study group and the control group were 6.6% and 4.9%, respectively, with no statistically significant difference between the two groups (P > 0.05). The operation time, depth of insertion and VAS score of the study group were all lower than the control group, and the differences between the two groups were statistically significant (all P< 0.05).The polyp detection rate of the study group and the control group was 19.7% and 13.1%respectively, and the difference was not statistically significant (P> 0.05).. Conclusion The application of colon hydrotherapy and PEG can be used as bowel preparation before colonoscopy for patients with constipation, and administration of PEG after colon hydrotherapy is much better.