Department of Medicine and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Canada.
PLoS One. 2019 Mar 28;14(3):e0211136. doi: 10.1371/journal.pone.0211136. eCollection 2019.
Colonoscopy remains the gold standard for the investigation of abnormalities within the colon. However, its success is highly dependent on the quality of bowel preparation. The objective of this study was to compare the bowel preparation efficacy of picosulfate/magnesium citrate (PMC) vs polyethylene glycol (PEG) in a one-day vs two-day split dose regimen.
A prospective, randomized, controlled trial was conducted at the Forzani & MacPhail Colon Cancer Screening Centre in Calgary, Canada. 171 colonoscopy outpatients were randomized to split-dose PMC or PEG lavage as well as into one-day split or two-day split regimens in blocks of eight. Bowel preparation quality was recorded in a blinded manner by the endoscopist using the Ottawa Bowel Preparation Scale (OBPS) prior to washing or suctioning. The scale results were analyzed using a two-factor analysis of variance.
141 patients received complete colonoscopies (PMC-71; PEG-70). PEG was found to be superior to PMC (mean OBPS: 4.14 ± 2.64 vs 5.11 ± 3.44, p = 0.019), when adjusted for administration regimen, leading to significantly more adequate bowel preparations (79.7% vs 59.7%, p = 0.007). A two-day split dose was superior to a one-day split dose regimen (mean OBPS: 3.68± 2.82 vs 5.69 ± 3.06, p<0.001). Two-day split dosing also resulted in a better right colon cleanliness score (right bowel OBPS 1.27±0.11 vs 2.10±0.12 for one-day split, P<0.001).
Optimal bowel preparation was achieved with the use of PEG lavage when administered in a two-day split dose regimen. This trial is registered with ClinicalTrials.gov under identifier NCT01415687.
结肠镜检查仍然是结肠内异常的金标准。然而，其成功率高度依赖于肠道准备的质量。本研究的目的是比较聚乙二醇（PEG）和匹可硫酸钠/柠檬酸镁（PMC）在一日和两日分次剂量方案中的肠道准备效果。
在加拿大卡尔加里的福扎尼和麦克菲尔结肠癌筛查中心进行了一项前瞻性、随机、对照试验。171 名结肠镜检查门诊患者随机分为分次剂量 PMC 或 PEG 灌洗，并按 8 例一组分为一日和两日分次剂量方案。肠道准备质量由内镜医师在冲洗或抽吸前使用渥太华肠道准备量表（OBPS）进行盲法记录。使用双因素方差分析对量表结果进行分析。
141 例患者接受了完整的结肠镜检查（PMC-71；PEG-70）。调整给药方案后，PEG 优于 PMC（平均 OBPS：4.14±2.64 对 5.11±3.44，p=0.019），导致肠道准备更充分（79.7%对 59.7%，p=0.007）。两日分次剂量方案优于一日分次剂量方案（平均 OBPS：3.68±2.82 对 5.69±3.06，p<0.001）。两日分次剂量方案还可改善右半结肠清洁评分（右半结肠 OBPS 1.27±0.11 对一日分次剂量方案的 2.10±0.12，p<0.001）。
在两日分次剂量方案中使用 PEG 灌洗可达到最佳肠道准备效果。该试验在 ClinicalTrials.gov 注册，标识符为 NCT01415687。
