Elitsur Rotem, Butcher Lisa, Vicki Lund, Elitsur Yoram
Rotem Elitsur, Lisa Butcher, Lund Vicki, Yoram Elitsur, Department of Pediatrics, Section of Gastroenterology, Marshall University School of Medicine, Huntington, WV 25701, United States.
World J Gastrointest Endosc. 2013 Apr 16;5(4):165-8. doi: 10.4253/wjge.v5.i4.165.
To compare between 2 and 4 d colon cleansing protocols.
Children who were scheduled for colonoscopy procedure (2010-2012) for various medical reasons, were recruited from the pediatric gastroenterology clinic at Marshall University School of Medicine, Huntington, WV. Exclusion criteria were patients who were allergic to the medication used in the protocols [polyethylene glycol (PEG) 3350, Bisacodyl], or children with metabolic or renal diseases. Two PEG 3350 protocols for 4 d (A) and 2 d (B) were prescribed as previously described. A questionnaire describing the volume of PEG consumed, clinical data, and side effects were recorded. Colon preparation was graded by two observers according to previously described method.
Rate of adequate colon preparation.
A total of 78 patients were considered for final calculation (group A: 40, group B: 38). Age and stool consistency at the last day was comparable in both groups, but the number of stools/day was significantly higher in group B (P = 0.001). Adequate colon preparation was reached in 57.5% (A) and 73.6% (B), respectively (P = 0.206). Side effects were minimal and comparable in both groups. There was no difference in children's age, stool characteristics, or side effects between the children with adequate or inadequate colon preparation. Correlation and agreement between observers was excellent (Pearson correlation = 0.972, kappa = 1.0).
No difference between protocols was observed, but the 2 d protocol was superior for its shorter time. Direct comparison between different colon cleansing protocols is crucial in order to establish the "gold standard" protocol for children.
比较2天和4天的结肠清洁方案。
因各种医学原因计划接受结肠镜检查(2010 - 2012年)的儿童,从西弗吉尼亚州亨廷顿马歇尔大学医学院儿科胃肠病诊所招募。排除标准为对方案中使用的药物[聚乙二醇(PEG)3350、比沙可啶]过敏的患者,或患有代谢或肾脏疾病的儿童。如前所述,规定了两种4天(A)和2天(B)的PEG 3350方案。记录一份描述PEG摄入量、临床数据和副作用的问卷。由两名观察者根据先前描述的方法对结肠准备情况进行分级。
充分结肠准备率。
共78例患者纳入最终计算(A组:40例,B组:38例)。两组最后一天的年龄和粪便稠度相当,但B组每天的排便次数显著更高(P = 0.001)。充分结肠准备率分别为57.5%(A组)和73.6%(B组)(P = 0.206)。两组的副作用均最小且相当。结肠准备充分或不充分的儿童在年龄、粪便特征或副作用方面无差异。观察者之间的相关性和一致性极佳(Pearson相关系数 = 0.972,kappa = 1.0)。
未观察到不同方案之间存在差异,但2天方案因其时间较短而更具优势。为确立儿童“金标准”方案,不同结肠清洁方案之间的直接比较至关重要。