Service d'Hépato-Gastro-Entérologie, Hôpital Edouard Herriot, Lyon, France.
Dig Liver Dis. 2013 Oct;45(10):820-6. doi: 10.1016/j.dld.2013.04.009. Epub 2013 Jun 14.
Patient acceptability of the preparation is a key factor in the success of colonoscopy, yet standard polyethylene glycol solutions are poorly tolerated owing to their high volume (4L) and low palatability. This study compared the efficacy, safety and acceptability of a 2L polyethylene glycol+ascorbate solution with a standard 4-L polyethylene glycol solution.
Adults referred for colonoscopy were randomised to 2-L polyethylene glycol+ascorbate (n=202) or 4-L polyethylene glycol solution (n=198). Colon cleansing success was assessed using the Harefield Cleansing Scale(©) and the Aronchick scale. Safety and acceptability were also assessed.
Successful cleansing was achieved in 94.1% and 90.9% of subjects with the 2-L and 4-L solutions respectively using the Harefield Cleansing Scale(©) and 94.6% and 90.0% using the Aronchick scale (non significant). Despite better acceptability and tolerability, no superiority over the standard 4-L preparation was demonstrated. Fewer treatment-related adverse events were reported with the 2-L solution (80.2% versus 89.9%, p=0.011). More subjects were willing to take the 2L PEG+ascorbate solution again (87% versus 51%, p<0.001), found it easier to drink (80% versus 70%, p=0.025), with a better taste (p=0.01).
Two-litre polyethylene glycol+ascorbate solution, with a similar high degree of cleansing and superior acceptability and tolerability, presents an alternative to 4-L polyethylene glycol when compliance is an issue.
患者对准备工作的接受程度是结肠镜检查成功的关键因素，但由于标准的聚乙二醇溶液体积大（4L）且口感不佳，因此患者的接受度较差。本研究比较了 2L 聚乙二醇+抗坏血酸溶液与标准 4L 聚乙二醇溶液的疗效、安全性和可接受性。
将接受结肠镜检查的成年人随机分为 2L 聚乙二醇+抗坏血酸组（n=202）或 4L 聚乙二醇溶液组（n=198）。使用 Harefield 清洁评分（©）和 Aronchick 评分评估结肠清洁成功情况。还评估了安全性和可接受性。
使用 Harefield 清洁评分（©），2L 和 4L 溶液组分别有 94.1%和 90.9%的受试者实现了成功清洁，使用 Aronchick 评分则分别为 94.6%和 90.0%（无显著差异）。尽管接受度和耐受性更好，但与标准 4L 制剂相比，没有显示出优越性。2L 溶液组报告的与治疗相关的不良事件更少（80.2%比 89.9%，p=0.011）。更多的受试者愿意再次服用 2L PEG+抗坏血酸溶液（87%比 51%，p<0.001），发现更容易饮用（80%比 70%，p=0.025），口感更好（p=0.01）。
2L 聚乙二醇+抗坏血酸溶液具有相似的高度清洁效果，且具有更高的可接受性和耐受性，在需要患者配合时，是 4L 聚乙二醇溶液的替代方案。
