Lever E L, Walter M H, Condon S C, Balasubramaniam K, Chen Y K, Mitchell R D, Herber R, Collen M J
Department of Medicine, Loma Linda University Medical Center, California.
Gastrointest Endosc. 1992 May-Jun;38(3):369-72. doi: 10.1016/s0016-5107(92)70435-0.
To evaluate whether the addition of enemas to oral electrolyte lavage is helpful for colonoscopic preparation, we conducted a prospective, randomized, observer-blinded trial to compare oral lavage plus enemas with oral lavage alone. The quality of preparation, mucosal visualization, and the volume of retained colonic fluid did not differ between the two groups. Twenty-two percent of the patients in the group who received oral lavage plus enemas compared with 12% of the patients in the group that only received oral lavage stated that they would refuse to repeat the preparation for future colonoscopic examination. Seventeen percent of the patients in the group that received oral lavage plus enemas demonstrated anorectal trauma or inflammation compared with only 5% in the group that received oral lavage alone (p = 0.09). These results indicate that the addition of enemas to oral lavage preparation for colonoscopic evaluation cannot be routinely recommended. However, enemas may be considered on an individual basis in the occasional patient unable to consume the complete oral lavage or in whom residual stool is found during colonoscopic evaluation after oral lavage preparation.
为评估在口服电解质灌洗基础上加用灌肠对结肠镜检查前肠道准备是否有益，我们进行了一项前瞻性、随机、观察者盲法试验，比较口服灌洗加灌肠与单纯口服灌洗的效果。两组在准备质量、黏膜可视化程度及结肠内残留液体量方面并无差异。接受口服灌洗加灌肠组中有22%的患者表示，他们会拒绝在未来结肠镜检查时重复这种准备方式，而单纯接受口服灌洗组这一比例为12%。接受口服灌洗加灌肠组中有17%的患者出现了肛肠创伤或炎症，而单纯接受口服灌洗组这一比例仅为5%（p = 0.09）。这些结果表明，在结肠镜检查评估的口服灌洗准备中常规加用灌肠不能得到推荐。然而，对于偶尔无法完成全部口服灌洗的患者，或在口服灌洗准备后结肠镜检查时发现有残留粪便的患者，可根据个体情况考虑使用灌肠。
