Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
Endoscopy. 2009 Dec;41(12):1038-45. doi: 10.1055/s-0029-1215333. Epub 2009 Dec 4.
Comparison of bowel preparation for colonoscopy in children with either Pico-Salax (sodium picosulphate with magnesium citrate) or polyethylene glycol with electrolyte solution (PEG-ELS).
In this investigator-blinded, randomized controlled trial, 83 children (12.5 +/- 3.1 years) requiring elective colonoscopy at a referral hospital were randomly allocated to Pico-Salax (n = 43) or PEG-ELS (n = 40), and an intention-to treat analysis was applied. Pico-Salax was administered in two doses, one the evening before and one on the morning of the procedure. PEG-ELS was administered over 4 hours. Efficacy was scored using the Ottawa scale and other constructs. Tolerability and toxicity were measured by patient and nursing questionnaires and serum biochemistry.
35 of Pico-Salax patients (81 %) were satisfied or very satisfied with the cleanout, compared with 19 (48 %) in the PEG-ELS group (P = 0.001). No differences were found in bowel cleanout effectiveness, as judged by the Ottawa score (P = 0.24), completion rates (P = 0.69), colonoscopy duration (P = 0.59), need for enemas (P = 0.25), or physician's global impression (P = 0.7). Except for one case of mild dehydration in the Pico-Salax group, no clinically significant adverse events were recorded. Serum biochemistry results were similar between groups except for more hypermagnesemia associated with Pico-Salax and hypokalemia with PEG-ELS; neither was clinically significant.
Children tolerate Pico-Salax better than PEG-ELS for bowel cleanout before colonoscopy. This study did not demonstrate superiority of effectiveness or safety for either regimen.
比较儿童用匹克沙洛（含柠檬酸镁的聚卡波非钙）或聚乙二醇电解质溶液（PEG-ELS）行结肠镜检查的肠道准备效果。
这是一项研究者设盲、随机对照试验，83 例（12.5±3.1 岁）在转诊医院行择期结肠镜检查的患儿被随机分配至匹克沙洛组（n=43）或 PEG-ELS 组（n=40），采用意向治疗分析。匹克沙洛分 2 次服用，一次在检查前一晚，一次在检查当天清晨。PEG-ELS 在 4 小时内服用。采用渥太华肠道准备量表及其他指标进行疗效评分。通过患者和护理人员问卷调查及血清生化检查来测量耐受性和毒性。
35 例（81%）匹克沙洛组患儿对肠道清洁效果满意或非常满意，而 PEG-ELS 组仅 19 例（48%）（P=0.001）。渥太华评分（P=0.24）、完成率（P=0.69）、结肠镜检查时间（P=0.59）、需要灌肠（P=0.25）或医师整体印象（P=0.7）等肠道清洁效果指标两组间无差异。除匹克沙洛组 1 例轻度脱水外，两组均无明显不良事件。两组间血清生化结果相似，仅匹克沙洛组更易发生轻度高镁血症和 PEG-ELS 组更易发生低钾血症，但均无临床意义。
与 PEG-ELS 相比，儿童行结肠镜检查前用匹克沙洛肠道准备的耐受性更好。本研究未显示出两种方案在有效性或安全性方面有优势。
