Department of Surgical Sciences, "Sapienza" University of Rome, 00161 Roma, Italy.
World J Gastroenterol. 2011 Nov 14;17(42):4689-95. doi: 10.3748/wjg.v17.i42.4689.
To investigate the effectiveness of low-volume plus ascorbic acid [polyethylene glycol plus ascorbic acid (PEG + Asc)] and high-volume plus simethicone [polyethylene glycol plus simethicone (PEG + Sim)] bowel preparations.
A total of one hundred and forty-four outpatients (76 males), aged from 20 to 84 years (median age 59.5 years), who attended our Department, were divided into two groups, age and sex matched, and underwent colonoscopy. Two questionnaires, one for patients reporting acceptability and the other for endoscopists evaluating bowel cleansing effectiveness according to validated scales, were completed. Indications, timing of examination and endoscopical findings were recorded. Biopsy forceps were used as a measuring tool in order to determine polyp endoscopic size estimation. Difficulty in completing the preparation was rated in a 5-point Likert scale (1 = easy to 5 = unable). Adverse experiences (fullness, cramps, nausea, vomiting, abdominal pain, headache and insomnia), number of evacuations and types of activities performed during preparation (walking or resting in bed) were also investigated.
Seventy-two patients were selected for each group. The two groups were age and sex matched as well as being comparable in terms of medical history and drug therapies taken. Fourteen patients dropped out from the trial because they did not complete the preparation procedure. Ratings of global bowel cleansing examinations were considered to be adequate in 91% of PEG + Asc and 88% of PEG + Sim patients. Residual Stool Score indicated similar levels of amount and consistency of residual stool; there was a significant difference in the percentage of bowel wall visualization in favour of PEG + Sim patients. In the PEG + Sim group, 12 adenomas ≤ 10 mm diameter (5/left colon + 7/right colon) vs 9 (8/left colon + 1/right colon) in the PEG + Asc group were diagnosed. Visualization of small lesions seems to be one of the primary advantages of the PEG + Sim preparation.
PEG + Asc is a good alternative solution as a bowel preparation but more improvements are necessary in order to achieve the target of a perfect preparation.
研究小容量加抗坏血酸[聚乙二醇加抗坏血酸（PEG+Asc）]和大容量加二甲硅油[聚乙二醇加二甲硅油（PEG+Sim）]肠道准备的效果。
共有 144 名 20 至 84 岁（中位年龄 59.5 岁）的门诊患者（76 名男性），按年龄和性别分为两组，并接受结肠镜检查。完成了两份问卷，一份是患者报告可接受性的问卷，另一份是内镜医师根据验证过的量表评估肠道清洁效果的问卷。记录了适应证、检查时间和内镜检查结果。活检钳被用作测量工具，以确定息肉的内镜大小估计。完成准备的难度被评为 5 分李克特量表（1=容易到 5=无法）。还调查了不良反应（饱胀感、痉挛、恶心、呕吐、腹痛、头痛和失眠）、排便次数和准备期间进行的活动类型（行走或卧床休息）。
每组选择 72 名患者。两组在年龄和性别上相匹配，在病史和服用的药物治疗方面也具有可比性。14 名患者因未完成准备程序而退出试验。91%的 PEG+Asc 和 88%的 PEG+Sim 患者的全球肠道清洁检查评分被认为是足够的。残留粪便评分表明残留粪便的数量和稠度相似；PEG+Sim 患者的肠道壁可视化百分比有显著差异。在 PEG+Sim 组中，诊断出 12 个直径≤10mm 的腺瘤（左半结肠 5 个/右半结肠 7 个），而 PEG+Asc 组中为 9 个（左半结肠 8 个/右半结肠 1 个）。PEG+Sim 准备的主要优势之一似乎是能够观察到小病变。
PEG+Asc 是一种很好的替代肠道准备方法，但需要进一步改进，以达到完美准备的目标。
