高剂量比沙可啶加水灌洗与口服磷酸钠作为门诊结肠镜检查肠道准备的比较。

High-dose bisacodyl plus water lavage compared with oral sodium phosphate as bowel preparation for outpatient colonoscopy.

作者信息

Chen Tai-An, Wong Hsin-Yung, Lin Chiun-Ku, Yu Hsien-Chung, Hsu Ping-I, Lo Gin-Ho, Lai Kwok-Hung

机构信息

Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, and School of Nursing, Fooyin University, Kaohsiung, Taiwan, R.O.C.

出版信息

J Chin Med Assoc. 2009 Aug;72(8):402-7. doi: 10.1016/S1726-4901(09)70396-X.

DOI:10.1016/S1726-4901(09)70396-X

PMID:19686995

Abstract

BACKGROUND

The aim of this prospective study was to compare the efficacy and patient compliance of an oral high dose of bisacodyl plus water lavage and oral sodium phosphate in adults undergoing elective colonoscopy.

METHODS

A total of 276 patients were randomized to receive an oral high-dose bisacodyl preparation (6 tablets of 5mg bisacodyl) plus water lavage (2 L of water) or an oral sodium phosphate (NaP) preparation (90 mL in divided doses). All endoscopic procedures were conducted in the afternoon. The endoscopist was blinded to the preparation the patient had received and graded the quality of colon cleansing as excellent, good, fair, poor, or failed. Patients' demographic data, indications for the procedure, and colonoscopic findings were recorded and compared.

RESULTS

Significantly improved (p < 0.001) bowel preparation after NaP compared with bisacodyl plus water lavage was reported. The completion rate of colonoscopy was significantly lower (p < 0.001) in the bisacodyl group (70.6%) than in the NaP group (92.9%). The detection of polyps was significantly increased (p = 0.017) in the NaP group (43.1%) compared with the bisacodyl group (27.1%). A procedural indication of constipation was an independent predictor of failed preparation in the bisacodyl group (odds ratio, 4.8; 95% confidence interval, 1.9-12.0; p < 0.001).

CONCLUSION

The quality of bowel preparation with oral NaP was better than that with bisacodyl plus water lavage.

摘要

背景

这项前瞻性研究的目的是比较口服大剂量比沙可啶加水灌洗和口服磷酸钠在接受择期结肠镜检查的成年人中的疗效和患者依从性。

方法

总共276名患者被随机分配接受口服大剂量比沙可啶制剂（6片5mg比沙可啶）加水灌洗（2L水）或口服磷酸钠（NaP）制剂（分剂量90mL）。所有内镜检查均在下午进行。内镜医师对患者所接受的制剂不知情，并将结肠清洁质量评为优秀、良好、中等、差或失败。记录并比较患者的人口统计学数据、检查指征和结肠镜检查结果。

结果

报告显示，与比沙可啶加水灌洗相比，NaP后的肠道准备有显著改善（p<0.001）。比沙可啶组的结肠镜检查完成率（70.6%）显著低于NaP组（92.9%）（p<0.001）。与比沙可啶组（27.1%）相比，NaP组（43.1%）息肉的检出率显著增加（p=0.017）。便秘的检查指征是比沙可啶组准备失败的独立预测因素（比值比，4.8；95%置信区间，1.9-12.0；p<0.001）。