Poon C M, Lee D W H, Mak S K, Ko C W, Chan K C, Chan K W, Sin K S, Chan A C W
Dept. of Surgery, North District Hospital, Sheung Shui, New Territories, Hong Kong Special Administrative Region, China.
Endoscopy. 2002 Jul;34(7):560-3. doi: 10.1055/s-2002-33207.
As a bowel cleansing agent for colonoscopy, sodium phosphate (NaP) has been reported to have equal effectiveness and better patient tolerance in comparison with 4 l polyethylene glycol-electrolyte lavage (PEG-EL) solution. Poor patient tolerance is frequently associated with a large amount of fluid consumed, and better patient tolerance might therefore be expected if the volume of PEG-EL solution could be reduced. This study aimed to compare 2 l PEG-EL solution with NaP in relation to patients' tolerance and its effectiveness as a bowel cleansing agent.
Two hundred consecutive patients admitted to the day-procedure ward for elective colonoscopy were prospectively randomized to receive either a 2-l PEG-EL solution or a 90-ml oral NaP regimen. Patients with a history of congestive heart failure, impaired renal function (creatinine > 1.5 mg/dl), or previous colectomy were excluded from the study. The patients completed a questionnaire to assess their tolerance of bowel preparation before the colonoscopy. Endoscopists, who were blinded to the type of regimen that had been used, scored the adequacy of bowel preparation from the rectum to cecum using a defined endoscopic score.
Two hundred patients were included in this randomized trial. Nine patients were excluded, due to either an incomplete questionnaire (two in the PEG-EL group, one in the NaP group) or inability to complete the bowel preparation regimen (four in the PEG-EL group and two in the NaP group). The demographic data were comparable in the two groups. There were no differences between the two groups with regard to willingness to repeat the regimen, ease of consumption, acceptability of the bowel preparation regimen, or the endoscopists' satisfaction with the quality of bowel preparation. The NaP group had a better mean endoscopic score at the cecum compared with the PEG-EL group (1.47 +/- 1.15 vs. 1.05 +/- 0.76; P = 0.007).
The effectiveness and patient tolerance of the 2-l PEG-EL solution is comparable with that of oral NaP. The 2-l PEG-EL solution is therefore an effective alternative as a bowel-cleansing agent for colonoscopy.
作为结肠镜检查的肠道清洁剂，据报道磷酸钠（NaP）与4升聚乙二醇电解质灌洗液（PEG - EL）相比，具有同等疗效且患者耐受性更好。患者耐受性差常与大量液体摄入有关，因此，如果能减少PEG - EL溶液的用量，可能会期望患者耐受性更好。本研究旨在比较2升PEG - EL溶液与NaP在患者耐受性及其作为肠道清洁剂的有效性方面的差异。
连续200例入住日间手术病房接受择期结肠镜检查的患者被前瞻性随机分为两组，分别接受2升PEG - EL溶液或90毫升口服NaP方案。有充血性心力衰竭病史、肾功能受损（肌酐>1.5毫克/分升）或既往接受过结肠切除术的患者被排除在研究之外。患者在结肠镜检查前完成一份问卷，以评估他们对肠道准备的耐受性。内镜医师在不知道所使用方案类型的情况下，使用定义的内镜评分对从直肠到盲肠的肠道准备充分程度进行评分。
200例患者纳入该随机试验。9例患者被排除，原因是问卷不完整（PEG - EL组2例，NaP组1例）或无法完成肠道准备方案（PEG - EL组4例，NaP组2例）。两组的人口统计学数据具有可比性。两组在重复该方案的意愿、饮用难易程度、肠道准备方案的可接受性或内镜医师对肠道准备质量的满意度方面没有差异。与PEG - EL组相比，NaP组在盲肠处的平均内镜评分更高（1.47±1.15对1.05±0.76；P = 0.007）。
2升PEG - EL溶液的有效性和患者耐受性与口服NaP相当。因此，2升PEG - EL溶液作为结肠镜检查的肠道清洁剂是一种有效的替代方案。
Zotero 插件