Tsuji S, Horiuchi A, Tamaki M, Ichise Y, Kajiyama M, Tanaka N
Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
Acta Gastroenterol Belg. 2018 Oct-Dec;81(4):485-489.
In an exploratory study we compared a new regimen of low-volume polyethylene glycol plus ascorbic acid (PEG-Asc) with the standard regimen for same-day bowel cleansing in constipated patients.
Between January and June 2015 we studied consecutive patients with constipation (Rome III constipation criteria) scheduled for colonoscopy. The initial group received the standard regimen of PEG-Asc. The subsequent group received the new regimen. The new regimen involved ingestion of 10 mL of sodium picosulfate and 50g of magnesium citrate dissolved in 0.2 L of water followed by 0.2 L of PEG-Asc +0.2 L of water given 6 or 7 times over 3 hours. Bowel cleansing was prospectively evaluated using the Boston bowel preparation scale (BBPS). Bowel cleansing, adenoma detection rates and adverse events were reviewed using electronic medical records and endoscopic filing system.
Sixty-two patients used the standard regimen and sixty used the new regimen. The basic characteristics of the two groups were similar. The mean volume of PEG-Asc and total liquid intake was less with the new regimen compared to the standard regimen (1.3 L vs. 2.0 L, P<0.001; 2.6 L vs. 3.0 L, P<0.001). The proportion of patients with a BBPS score ≥ 6 was significantly greater with the new than the standard regimen (93% vs. 76%, P=0.008). Nausea and/or vomiting was also significantly less frequent than with the standard regimen (5% vs. 16%, P=0.046).
The new regimen of PEG-Asc gave improved same-day bowel cleansing for colonoscopy in constipated patients.
在一项探索性研究中，我们将低容量聚乙二醇加抗坏血酸（PEG-Asc）的新方案与便秘患者同日肠道准备的标准方案进行了比较。
2015年1月至6月期间，我们研究了连续入选的符合罗马III型便秘标准且计划行结肠镜检查的患者。初始组接受PEG-Asc标准方案。后续组接受新方案。新方案为服用10 mL比沙可啶钠和50 g柠檬酸镁溶于0.2 L水中，随后在3小时内分6或7次给予0.2 L PEG-Asc加0.2 L水。使用波士顿肠道准备量表（BBPS）对肠道准备情况进行前瞻性评估。通过电子病历和内镜存档系统回顾肠道准备情况、腺瘤检出率及不良事件。
62例患者使用标准方案，60例使用新方案。两组的基本特征相似。与标准方案相比，新方案的PEG-Asc平均用量和总液体摄入量更少（1.3 L对2.0 L，P<0.001；2.6 L对3.0 L，P<0.001）。新方案中BBPS评分≥6的患者比例显著高于标准方案（93%对76%，P=0.008）。恶心和/或呕吐的发生率也显著低于标准方案（5%对16%，P=0.046）。
PEG-Asc新方案在便秘患者结肠镜检查的同日肠道准备方面效果更佳。
