Indiana University School of Medicine, Department of Medicine, 550 University Boulevard, Indianapolis, IN 46202, USA.
Nat Rev Gastroenterol Hepatol. 2014 Jul;11(7):419-25. doi: 10.1038/nrgastro.2014.35. Epub 2014 Apr 1.
High-quality bowel preparation is essential for effective colonoscopy. Bowel preparations are judged by their safety, efficacy and tolerability. Between efficacy and tolerability, efficacy is the clinical priority because inadequate preparations are disruptive and costly. Achieving high rates of adequate preparation depends first on using split-dose or same-day dosing. Patients who have medical predictors of inadequate preparation quality (for example chronic constipation) should be prescribed more aggressive preparations and patients who have factors that predict they are less likely to follow the instructions (such as English not being their first language) should receive intensified education. On the day of the procedure, patients with persistent brown effluent should be considered for large-volume enemas or additional oral preparation before proceeding with colonoscopy. During the procedure, preparation quality should be graded after the clean-up has been completed.
高质量的肠道准备对于有效的结肠镜检查至关重要。肠道准备的安全性、有效性和耐受性是评判的标准。在有效性和耐受性之间，有效性是临床的首要关注点，因为不充分的准备会带来干扰和成本。实现高比例的充分准备首先取决于使用分剂量或同日剂量给药。对于有肠道准备质量不足的医学预测因素（例如慢性便秘）的患者，应开处方更积极的准备药物，而对于那些有预测他们不太可能遵循说明的因素（例如英语不是他们的第一语言）的患者，应接受强化教育。在手术当天，对于持续出现棕色排泄物的患者，应考虑在进行结肠镜检查前进行大容量灌肠或额外的口服准备。在手术过程中，在完成清洗后应对肠道准备质量进行分级。
