Wen Chia-Cheng, Jao Shu-Wen, Hsiao Cheng-Wen
Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Med Sci Monit. 2017 Jun 26;23:3123-3129. doi: 10.12659/msm.905431.
BACKGROUND A complete cleansing of the bowel is a critical factor that impacts the diagnostic accuracy of colonoscopies. However, the common bowel preparation regimen of two 45 mL doses of sodium phosphate (2×NaP) often leads to uncomfortable symptoms and subsequently lower patient adherence. To improve patient adherence and satisfaction, we proposed a modified regimen composed of two sennoside tablets and one bottle of NaP (S+NaP) and we then evaluated bowel preparation quality and patient satisfaction. MATERIAL AND METHODS A total of 531 patients who underwent colonoscopies at the outpatient coloproctology clinic from January 2016 to December 2016 were retrospectively reviewed. Eligible patients were divided into two groups: S+NaP group (n=93) and 2×NaP group (n=60). We compared bowel preparation quality, adenoma detection rate (ADR), self-reported patient satisfaction scores, and adverse events among the two groups. RESULTS Regarding high bowel preparation quality, our results showed that there was no significant difference among the two groups (p=0.775), as well as no significant differences in ADRs (p=0.187). However, a lower proportion of nausea was found in the S+NaP group compared to the 2×NaP group (24.7% versus 41.7%, respectively, p=0.028). In addition, patients in the S+NaP group were more likely to be very satisfied with the regimen compared with patients in the 2×NaP group (odds ratio: 5.58; 95% confidence interval: 2.36-13.213, p<0.001). CONCLUSIONS Our modified bowel preparation regimen, S+NaP, yielded significantly higher patient satisfaction with less nausea while maintaining similar bowel preparation quality.
背景 肠道的彻底清洁是影响结肠镜检查诊断准确性的关键因素。然而，常用的45毫升两剂磷酸钠（2×NaP）肠道准备方案常常会导致不适症状，进而降低患者的依从性。为了提高患者的依从性和满意度，我们提出了一种改良方案，即两片番泻苷片加一瓶NaP（S+NaP），然后我们评估了肠道准备质量和患者满意度。
材料与方法 回顾性分析了2016年1月至2016年12月在门诊结肠直肠科接受结肠镜检查的531例患者。符合条件的患者分为两组：S+NaP组（n=93）和2×NaP组（n=60）。我们比较了两组的肠道准备质量、腺瘤检出率（ADR）、患者自我报告的满意度评分以及不良事件。
结果 关于高质量的肠道准备，我们的结果显示两组之间没有显著差异（p=0.775），ADR也没有显著差异（p=0.187）。然而，与2×NaP组相比，S+NaP组恶心的比例较低（分别为24.7%和41.7%，p=0.028）。此外，与2×NaP组的患者相比，S+NaP组的患者对该方案更有可能非常满意（优势比：5.58；95%置信区间：2.36-13.213，p<）。
结论 我们改良的肠道准备方案S+NaP在保持相似肠道准备质量的同时，患者满意度显著更高，恶心症状更少。
