低容量聚乙二醇溶液与次优肠道准备率增加相关，但在早期重复结肠镜检查的建议、操作时间和腺瘤检出率方面具有相似性。
A low-volume polyethylene glycol solution was associated with an increased suboptimal bowel preparation rate but had similar recommendations for an early repeat colonoscopy, procedure times, and adenoma detection rates.
作者信息
Hankins Sam C, Brimhall Bryan B, Kankanala Vineel, Austin Gregory L
机构信息
University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America.
出版信息
PLoS One. 2017 Apr 27;12(4):e0176265. doi: 10.1371/journal.pone.0176265. eCollection 2017.
BACKGROUND/AIMS: Low-volume polyethylene glycol (PEG) bowel preparations are better tolerated by patients than high-volume preparations and may achieve similar preparation quality. However, there is little data comparing their effects on a recommendation for an early repeat colonoscopy (because of a suboptimal preparation), procedure times, adenoma detection rate (ADR), and advanced adenoma detection rate (AADR).
METHODS
This is a retrospective cohort study of outpatient colonoscopies performed during a one-year period at a single academic medical center in which low-volume MoviPrep® (n = 1841) or high-volume Colyte® (n = 1337) was used. All preparations were split-dosed. Appropriate covariates were included in regression models assessing suboptimal preparation quality (fair, poor, or inadequate), procedure times, recommendation for an early repeat colonoscopy, ADR, and AADR.
RESULTS
MoviPrep® was associated with an increase in having a suboptimal bowel preparation (OR 1.36; 95% CI: 1.06-1.76), but it was not associated with differences in insertion (p = 0.43), withdrawal (p = 0.22), or total procedure times (p = 0.10). The adjusted percentage with a suboptimal preparation was 11.7% for patients using MoviPrep® and 8.8% for patients using Colyte®. MoviPrep® was not associated with a significant difference in overall ADR (OR 0.93; 95% CI: 0.78-1.11), AADR (OR 1.18; 95% CI: 0.87-1.62), or recommendation for early repeat colonoscopy (OR 1.16; 95% CI: 0.72-1.88).
CONCLUSIONS
MoviPrep® was associated with a small absolute increase in having a suboptimal preparation, but did not affect recommendations for an early repeat colonoscopy, procedure times, or adenoma detection rates. Mechanisms to reduce financial barriers limiting low-volume preparations should be considered because of their favorable tolerability profile.
背景/目的：与大容量聚乙二醇（PEG）肠道准备相比，小容量PEG肠道准备受患者的耐受性更好，且可能达到相似的准备质量。然而，关于它们对早期重复结肠镜检查建议（因准备不充分）、操作时间、腺瘤检出率（ADR）和高级别腺瘤检出率（AADR）影响的比较数据很少。
方法
这是一项对在单一学术医学中心进行的为期一年的门诊结肠镜检查的回顾性队列研究，其中使用了小容量的MoviPrep®（n = 1841）或大容量的Colyte®（n = 1337）。所有准备均采用分剂量给药。在评估准备质量欠佳（一般、差或不充分）、操作时间、早期重复结肠镜检查建议、ADR和AADR的回归模型中纳入了适当的协变量。
结果
MoviPrep®与肠道准备欠佳的发生率增加相关（比值比1.36；95%置信区间：1.06 - 1.76），但与插入时间（p = 0.43）、退镜时间（p = 0.22）或总操作时间（p = 0.10）的差异无关。使用MoviPrep®的患者准备质量欠佳的校正百分比为11.7%，使用Colyte®的患者为8.8%。MoviPrep®与总体ADR（比值比0.93；95%置信区间：0.78 - 1.11）、AADR（比值比1.18；95%置信区间：0.87 - 1.62）或早期重复结肠镜检查建议（比值比1.16；95%置信区间：0.72 - 1.88）的显著差异无关。
结论
MoviPrep®与准备质量欠佳的绝对发生率小幅增加相关，但不影响早期重复结肠镜检查建议、操作时间或腺瘤检出率。鉴于小容量制剂具有良好的耐受性，应考虑采取措施减少限制其使用的经济障碍。
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