Yoshida Naohisa, Naito Yuji, Murakami Takaaki, Hirose Ryohei, Ogiso Kiyoshi, Inada Yutaka, Dohi Osamu, Okayama Tetsuya, Kamada Kazuhiro, Uchiyama Kazuhiko, Ishikawa Takeshi, Handa Osamu, Konishi Hideyuki, Siah Kewin Tien Ho, Yagi Nobuaki, Itoh Yoshito
Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Division of Gastroenterology and Hepatology, University Medicine Cluster, National University Hospital, Singapore, Singapore.
Dig Dis Sci. 2016 Nov;61(11):3229-3235. doi: 10.1007/s10620-016-4262-7. Epub 2016 Aug 3.
A same-day low-volume 1 L polyethylene glycol (PEG) for bowel preparation before colonoscopy was developed to improve patients' compliance. We aimed to evaluate the efficacy and safety of this regimen especially for the elderly and patients with renal dysfunction.
All consecutive patients who underwent colonoscopy in our center from November 2014 to September 2015 were included. Patients undertook a low-residue diet with 10 mL sodium picosulfate 1 day before colonoscopy. Subsequently, they had 1 L low-volume PEG (MoviPrep) and 0.5 L water 4 h before the examination. Clinical outcomes, including cleansing level using the Boston bowel preparation score (BBPS), in the elderly and special-elderly (65-79 and ≥80 years old) were analyzed and compared with the non-elderly (18-64 years old). Additionally, patients with renal dysfunction were analyzed with respect to both complications and changes in blood parameters.
A total of 5427 patients (mean age: 64.5 ± 13.8) were analyzed. The rate of BBPS ≥ 6 in the elderly (2761 patients), special-elderly (565 patients), and non-elderly (2101 patients) was 94.1, 91.8, and 94.6 %, respectively. In the special-elderly, the rate of renal dysfunction was 14.8 %, and no severe complications were detected after colonoscopy. Additionally, there were no severe complications in 86 patients with renal dysfunction, though elevation of hematocrit was shown after intake of 1 L PEG (before, 36.7 ± 6.1 vs. after, 39.0 ± 5.7, P = 0.006).
Our study shows the safety and efficacy of same-day low-volume 1 L PEG bowel preparation in colonoscopy for the elderly and patients with renal dysfunction.
为提高患者的依从性，研发了一种用于结肠镜检查前肠道准备的当日低容量1升聚乙二醇（PEG）方案。我们旨在评估该方案的有效性和安全性，特别是针对老年人和肾功能不全患者。
纳入2014年11月至2015年9月在本中心接受结肠镜检查的所有连续患者。患者在结肠镜检查前1天采用低渣饮食，并服用10毫升匹可硫酸钠。随后，在检查前4小时服用1升低容量PEG（MoviPrep）和0.5升水。分析了老年人和特殊老年人（65 - 79岁和≥80岁）的临床结局，包括使用波士顿肠道准备评分（BBPS）评估的清洁程度，并与非老年人（18 - 64岁）进行比较。此外，对肾功能不全患者的并发症和血液参数变化进行了分析。
共分析了5427例患者（平均年龄：64.5±13.8）。老年人（2761例）、特殊老年人（565例）和非老年人（2101例）中BBPS≥6的比例分别为94.1%、91.8%和94.6%。在特殊老年人中，肾功能不全的发生率为14.8%，结肠镜检查后未发现严重并发症。此外，86例肾功能不全患者也未出现严重并发症，尽管在服用1升PEG后血细胞比容有所升高（服药前，36.7±6.1 vs.服药后，39.0±5.7，P = 0.006）。
我们的研究表明，当日低容量1升PEG肠道准备方案在结肠镜检查中对老年人和肾功能不全患者具有安全性和有效性。
