Kmochova Klara, Grega Tomas, Ngo Ondrej, Vojtechova Gabriela, Majek Ondrej, Urbanek Petr, Zavoral Miroslav, Suchanek Stepan
Department of Medicine, 1st Faculty of Medicine, Charles University and Military University Hospital, Prague, Czech Republic. .
Department of Medicine, 1st Faculty of Medicine, Charles University and Military University Hospital, Prague, Czech Republic.
J Gastrointestin Liver Dis. 2021 Jun 18;30(2):213-220. doi: 10.15403/jgld-3401.
Adequate bowel preparation is essential for successful and effective colonoscopy. Several types of cleansing agents are currently available including low-volume solutions. The aim of this study was to compare the efficacy of four different bowel cleansing agents.
A single-center, prospective, randomized, and single-blind study was performed. Consecutive patients referred for colonoscopy were enrolled and randomized into one of the following types of laxatives: polyethylenglycol 4L (PEG), oral sulfate solution (OSS), 2L polyethylenglycol + ascorbate (2L-PEG/Asc), or magnesium citrate + sodium picosulfate (MCSP). The primary outcome was quality of bowel cleansing evaluated according to the Boston Bowel Preparation Scale (BBPS). Secondary outcomes were polyp detection rate (PDR) and tolerability.
Final analysis was performed on 431 patients. The number of patients with adequate bowel preparation (BBPS total scores ≥6 and sub scores ≥2 in each segment) was not significantly different throughout all groups (95.4% PEG; 94.6% OSS; 96.3% 2L-PEG/Asc; 96.2% MCSP; p=0.955). Excellent bowel preparation (BBPS total scores ≥ 8) was associated with younger age (p=0.007). The groups did not have significantly different PDRs (49.5% PEG; 49.1% OSS; 38% 2L-PEG/Asc; 40.4% MCSP; p=0.201). The strongest predictors of pathology identification were age and male gender. The best-tolerated solution was MCSP (palatability: p<0.001; nausea: p=0.024).
充分的肠道准备对于成功且有效的结肠镜检查至关重要。目前有多种类型的清洁剂可供使用，包括低容量溶液。本研究的目的是比较四种不同肠道清洁剂的疗效。
进行了一项单中心、前瞻性、随机、单盲研究。连续入选因结肠镜检查而转诊的患者，并随机分为以下几种泻药类型之一：4L聚乙二醇（PEG）、口服硫酸盐溶液（OSS）、2L聚乙二醇+抗坏血酸盐（2L-PEG/Asc）或枸橼酸镁+匹可硫酸钠（MCSP）。主要结局是根据波士顿肠道准备量表（BBPS）评估的肠道清洁质量。次要结局是息肉检出率（PDR）和耐受性。
对431例患者进行了最终分析。所有组中肠道准备充分（BBPS总分≥6且各节段子分数≥2）的患者数量无显著差异（PEG组为95.4%；OSS组为94.6%；2L-PEG/Asc组为96.3%；MCSP组为96.2%；p = 0.955）。良好的肠道准备（BBPS总分≥8）与较年轻的年龄相关（p = 0.007）。各组的PDR无显著差异（PEG组为49.5%；OSS组为49.1%；2L-PEG/Asc组为38%；MCSP组为40.4%；p = 0.201）。病理识别的最强预测因素是年龄和男性性别。耐受性最佳的溶液是MCSP（口感：p < 0.001；恶心：p = 0.024）。
