液体摄入量对儿童便秘结局的影响：聚乙二醇4000与乳果糖的比较

Effect of fluid intake on the outcome of constipation in children: PEG 4000 versus lactulose.

作者信息

Bae Sun Hwan, Son Jae Sung, Lee Ran

机构信息

Department of Pediatrics, Konkuk University, School of Medicine, Seoul, South Korea.

出版信息

Pediatr Int. 2010 Aug;52(4):594-7. doi: 10.1111/j.1442-200X.2009.03017.x.

DOI:10.1111/j.1442-200X.2009.03017.x

PMID:20003145

Abstract

BACKGROUND

The aim of the present study was to evaluate the effect of fluid intake on the outcome of treatment with osmotic laxatives, PEG 4000 and lactulose, in children with chronic constipation.

METHODS

Medical records were reviewed, and 27 children with chronic constipation satisfying the following criteria were enrolled: (i) on stable maintenance medication for ≥ 3 months; (ii) no dosage modification or drug change between the two periods compared; (iii) no clinical events during the investigation that could affect intake or the clinical outcomes; (iv) good compliance regarding inclusion in the diaries of the frequency of bowel movements, the consistency of stools, and the amount of fluid intake. The diary covered > 25 days per visit; and (v) interval of < 3 months between the two periods compared. A scoring system was developed for bowel movements and for stool consistency. The score during a period of better fluid intake was compared to that during a period of worse fluid intake, for the same patient. Wilcoxon signed-rank test was used for the analysis.

RESULTS

On polyethylene glycol 4000 (PEG 4000; n = 14), the bowel movement score on good fluid intake was 21.43-30.00 (median, 27.78), while that on poor fluid intake was 19.00-30.00 (median, 25.13; P = 0.009). For stool consistency, the score on good fluid intake was 11.79-20.00 (median, 20.00), while that on poor fluid intake was 11.00-25.00 (median, 15.91; P = 0.002). On lactulose (n = 13) there was no statistical difference with respect to the two categories of defecation.

CONCLUSIONS

Children who are already on PEG 4000 still benefit from additional fluid intake.

摘要

背景

本研究旨在评估液体摄入量对慢性便秘儿童使用渗透性泻药聚乙二醇4000（PEG 4000）和乳果糖治疗效果的影响。

方法

回顾病历，纳入27例符合以下标准的慢性便秘儿童：（i）稳定维持用药≥3个月；（ii）在比较的两个时间段内未调整剂量或更换药物；（iii）调查期间无可能影响摄入量或临床结局的临床事件；（iv）在排便频率、粪便稠度和液体摄入量日记记录方面依从性良好。每次访视日记记录天数>25天；（v）比较的两个时间段间隔<3个月。为排便和粪便稠度制定了评分系统。对同一患者在液体摄入量较好时期的评分与液体摄入量较差时期的评分进行比较。采用Wilcoxon符号秩检验进行分析。

结果

在使用聚乙二醇4000（PEG 4000；n = 14）时，液体摄入量良好时的排便评分是21.43 - 30.00（中位数，27.78），而液体摄入量较差时为19.00 - 30.00（中位数，25.13；P = 0.009）。对于粪便稠度，液体摄入量良好时的评分是11.79 - 20.00（中位数，20.00），而液体摄入量较差时为11.00 - 25.00（中位数，15.91；P = 0.002）。在使用乳果糖（n = 13）时，两类排便情况无统计学差异。