Internal Medicine and Gastroenterology, Atrium Medical Center Parkstad, Heerlen, The Netherlands.
Eur J Gastroenterol Hepatol. 2011 Oct;23(10):897-902. doi: 10.1097/MEG.0b013e32834a3444.
A good bowel preparation is essential for optimal visualization of the large intestine. Several preparations with a difference in composition and volume are available. We compared five methods for bowel cleansing quality and patients' acceptability.
Adult ambulatory outpatients scheduled for elective colonoscopy were randomized to receive 4-l polyethylene glycol (PEG) solution (Klean-prep), 2-l PEG solution+ascorbic acid (Moviprep), or a sodium phosphate (NaP) solution, Phosphoral. Patients with the PEG solutions were also randomized to receive simethicone (Aeropax), to investigate whether this improves the bowel cleansing efficacy. Before colonoscopy patients completed a questionnaire about the acceptability and tolerability of the preparation. Endoscopists blinded to the type of preparation gave a bowel cleansing score.
Data were available for 461 patients. 2-l PEG+ascorbic acid was noninferior to 4-l PEG in bowel cleansing quality of rectosigmoid and colon. NaP was noninferior to 4-l PEG in bowel cleansing quality of rectosigmoid but inferior for the whole colon. Compliance was significantly less in the group with 4-l PEG compared with the 2-l PEG and NaP group. No difference was found for abdominal cramps. Taste was significantly better in the 2-l PEG group. Simethicone did not improve the bowel cleansing quality.
2-l PEG+ascorbic acid was noninferior to the 4-l PEG solution in bowel cleansing quality and was better in taste and compliance. NaP was inferior to 4-l PEG in bowel cleansing quality. Addition of simethicone gave no improvement.
良好的肠道准备对于优化大肠可视化至关重要。有多种组成和容量不同的制剂可供选择。我们比较了五种肠道清洁质量和患者接受度的方法。
择期行结肠镜检查的成年门诊患者被随机分为接受 4 升聚乙二醇（PEG）溶液（Klean-prep）、2 升 PEG 溶液+抗坏血酸（Moviprep）或磷酸钠（NaP）溶液（Phosphoral）。接受 PEG 溶液的患者也被随机分为接受二甲硅油（Aeropax）组，以研究是否可以提高肠道清洁效果。在结肠镜检查前，患者完成了一份关于准备工作的可接受性和耐受性的问卷。内镜医师对制剂类型进行了盲法评估，并给出了肠道清洁评分。
共有 461 名患者的数据可用。2 升 PEG+抗坏血酸在直肠乙状结肠和结肠的肠道清洁质量方面不劣于 4 升 PEG。NaP 在直肠乙状结肠的肠道清洁质量方面不劣于 4 升 PEG，但在整个结肠方面较差。与 2 升 PEG 和 NaP 组相比，4 升 PEG 组的依从性显著降低。腹部痉挛无差异。2 升 PEG 组的口感明显更好。二甲硅油并未改善肠道清洁质量。
2 升 PEG+抗坏血酸在肠道清洁质量方面不劣于 4 升 PEG 溶液，且在口感和依从性方面更好。NaP 在肠道清洁质量方面劣于 4 升 PEG。添加二甲硅油并没有改善效果。
