Chen Huimin, Li Xiaobo, Ge Zhizheng
Department of Gastroenterology, Shanghai Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China.
Scand J Gastroenterol. 2009;44(3):375-9. doi: 10.1080/00365520802538211.
To determine the efficacy, tolerance, and safety of oral sodium phosphate compared with polyethylene glycol in patients with chronic constipation.
From May 2007 to October 2007, 100 patients with chronic constipation were prospectively randomized into two groups for colonoscopy. Group A (n=49) received sodium phosphate before colonoscopy, while Group B (n=51) received polyethylene glycol. During the same period, another 50 patients in Group C with normal defecation function were enrolled and received the polyethylene glycol preparation. Patients with intestinal stenosis found by colonoscopy were excluded. The quality of preparation was assessed by the endoscopist, who was blinded to the types of bowel preparation. Laboratory examinations including hematocrit, serum phosphorous, serum calcium, blood urea nitrogen, and serum creatinine were carried out in Groups A and B before and after preparation. A questionnaire was used to assess adverse effects and patients' tolerance to the bowel preparation.
Two patients in Group A with a diagnosis of malignant tumor detected by colonoscopy were excluded. The baseline parameters, including weight, age, gender, endoscopic diagnosis, or constipation status, were homogeneously distributed in the three groups. It was shown that the quality of preparation in Group B was poorer than that in Group C (p<0.05). Compared with Group B, Group A showed better quality of preparation, a smaller amount of intestinal air bubble, and a higher number of defecations after taking the medicine (p<0.05 for all). There were no significant differences in acceptance of the two preparations and the prevalence of adverse effects. Transient hyperphosphatasemia was noted in four patients in Group A, but neither clinical symptoms nor hypocalcemia was observed.
Based on our preliminary study, in the preparation of patients with chronic constipation for colonoscopy, sodium phosphate is just as well tolerated and safe as a standard polyethylene glycol preparation and might provide a better quality of bowel preparation.
比较口服磷酸钠与聚乙二醇在慢性便秘患者中的疗效、耐受性和安全性。
2007年5月至2007年10月，100例慢性便秘患者被前瞻性随机分为两组进行结肠镜检查。A组（n = 49）在结肠镜检查前服用磷酸钠，B组（n = 51）服用聚乙二醇。同期，招募了另外50例排便功能正常的C组患者并给予聚乙二醇制剂。排除结肠镜检查发现的肠道狭窄患者。由对肠道准备类型不知情的内镜医师评估准备质量。A组和B组在准备前后进行了包括血细胞比容、血清磷、血清钙、血尿素氮和血清肌酐在内的实验室检查。使用问卷评估不良反应和患者对肠道准备的耐受性。
A组中有2例经结肠镜检查诊断为恶性肿瘤的患者被排除。三组的基线参数，包括体重、年龄、性别、内镜诊断或便秘状况，分布均匀。结果显示，B组的准备质量比C组差（p < 0.05）。与B组相比，A组的准备质量更好，肠道气泡量更少，服药后排便次数更多（均p < 0.05）。两种制剂的接受度和不良反应发生率无显著差异。A组有4例患者出现短暂性高磷血症，但未观察到临床症状或低钙血症。
基于我们的初步研究，在为慢性便秘患者进行结肠镜检查准备时，磷酸钠的耐受性和安全性与标准聚乙二醇制剂相当，并且可能提供更好的肠道准备质量。
