Tepeš Bojan, Mlakar Dominika N, Metličar Tanja
aAM DC Rogaška, Rogaška Slatina bNational Institute of Public Health, Ljubljana, Slovenia.
Eur J Gastroenterol Hepatol. 2014 Jun;26(6):616-20. doi: 10.1097/MEG.0000000000000093.
Patient compliance with bowel cleansing procedures represents one of the most objectionable aspects of colonoscopy. Adverse reactions to the purgative may result in failure to complete the preparation, inadequate visualization of the colon, polyp and even carcinoma miss rate and unwillingness to attend a follow-up colonoscopy. The primary objective of the study was to evaluate the effectiveness of bowel cleansing with magnesium sulphate and low-volume polyethylene glycol (PEG) with electrolytes. The second objective was to evaluate whether bowel cleansing was better in participants scheduled for morning colonoscopies or afternoon colonoscopies.
Magnesium sulphate mineral water (2 l) and 2 l of low-volume PEG and electrolytes solution were used as our bowel cleansing protocol. A total of 13 914 participants, who participated in the Slovenian colorectal cancer screening programme in the period between 2009 and 2011, were included.
Excellent bowel preparation was achieved in 11 484 (82.61%) participants; 1894 (13.62%) participants had good bowel preparation, 439 (3.16%) participants had fair bowel preparation and 85 (0.61%) participants had poor bowel preparation. Better results were achieved in the afternoon colonoscopies and in younger participant groups (P<0.001). No serious side effects of bowel cleansing were reported.
This is the first study to use magnesium sulphate mineral water and PEG plus electrolytes for bowel cleansing. We found excellent bowel cleansing in 82.61% participants and in more participants if colonoscopy was performed in the afternoon.
患者对肠道清洁程序的依从性是结肠镜检查中最令人反感的方面之一。泻药的不良反应可能导致准备工作无法完成、结肠可视化不足、息肉甚至癌症漏诊率以及不愿接受后续结肠镜检查。本研究的主要目的是评估硫酸镁和低容量聚乙二醇(PEG)加电解质进行肠道清洁的有效性。第二个目的是评估安排在上午进行结肠镜检查的参与者与安排在下午进行结肠镜检查的参与者相比,肠道清洁效果是否更好。
我们采用2升硫酸镁矿泉水和2升低容量PEG加电解质溶液作为肠道清洁方案。纳入了2009年至2011年期间参加斯洛文尼亚结直肠癌筛查计划的13914名参与者。
11484名(82.61%)参与者实现了良好的肠道准备;1894名(13.62%)参与者肠道准备良好,439名(3.16%)参与者肠道准备一般,85名(0.61%)参与者肠道准备较差。下午进行结肠镜检查的参与者以及较年轻的参与者组取得了更好的结果(P<0.001)。未报告肠道清洁的严重副作用。
这是第一项使用硫酸镁矿泉水和PEG加电解质进行肠道清洁的研究。我们发现82.61%的参与者肠道清洁良好,并且如果在下午进行结肠镜检查,肠道清洁良好的参与者更多。