Wu Le-Can, Zheng En-Dian, Sun Hao-Yue, Lin Xi-Zhou, Pan Ju-Yi, Lin Xiao-Xiao
Department of Gastroenterology, Wenzhou People's Hospital, The Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang, China.
Front Oncol. 2023 Apr 14;13:1038461. doi: 10.3389/fonc.2023.1038461. eCollection 2023.
This study explored the effectiveness and safety of low-volume polyethylene glycol electrolyte lavage solution (PEG-ELS) combined with ascorbic acid tablets (PEG-ELS/Asc) in bowel preparation for a colonoscopy.
A total of 240 hospitalized patients who underwent a colonoscopy in Wenzhou People's Hospital, Wenzhou Third Clinical College of Wenzhou Medical University from July 2020 to June 2022 were randomly divided into two groups, with 120 patients each. All of the participants were given a low-residue or residue-free diet one day before the examination and fasted after dinner (completed before 18:00) the day before the examination. The 2-L PEG-ELS/Asc group took 2-L PEG-ELS plus 10 g ascorbic acid tablets once orally, while the 3-L PEG-ELS group took 3-L PEG orally on several occasions. The primary endpoint was the achievement of preparation adequacy and an overall colon cleansing score of ≥6, both assessed by blinded investigators using the Boston Bowel Preparation Scale (BBPS). The bowel cleansing effect, polyp detection rate, adverse reaction rate, oral drug tolerance rate, renal function, and electrolyte level changes were also compared between the two patient groups.
There were no significant differences in the success rate of bowel preparation, the detection rate of polyps, or the adverse reaction rate between the two groups ( > 0.05). The tolerance rate of bowel preparation in the 2-L PEG-ELS/Asc group was significantly higher than that in the 3-L PEG-ELS group (93.3% vs. 80.23%) ( < 0.05). The levels of creatinine, serum potassium, serum sodium, and serum chlorine of the two groups before and after bowel preparation were within the normal range. In addition, the intestinal cleaning effect of the two preparation schemes for the hospitalized patients with diabetes and constipation is worse than that of those without these conditions ( < 0.05).
The effectiveness and safety of using 2-L PEG-ELS/Asc in bowel preparation for a colonoscopy in hospitalized patients were not inferior to using 3-L PEG-ELS. For patients with diabetes and constipation, the cleansing effect of the two bowel preparation options was not very satisfactory, and further clinical research is needed in this regard.
本研究探讨了小剂量聚乙二醇电解质灌洗液（PEG - ELS）联合抗坏血酸片（PEG - ELS/Asc）在结肠镜检查肠道准备中的有效性和安全性。
选取2020年7月至2022年6月在温州医科大学附属第三临床学院温州市人民医院接受结肠镜检查的240例住院患者，随机分为两组，每组120例。所有参与者在检查前一天给予低渣或无渣饮食，检查前一天晚餐后禁食（18:00前完成）。2升PEG - ELS/Asc组口服2升PEG - ELS加10克抗坏血酸片一次，而3升PEG - ELS组多次口服3升PEG。主要终点是达到准备充分性且总体结肠清洁评分≥6，均由盲法研究者使用波士顿肠道准备量表（BBPS）进行评估。还比较了两组患者的肠道清洁效果、息肉检出率、不良反应发生率、口服药物耐受率、肾功能及电解质水平变化。
两组在肠道准备成功率、息肉检出率或不良反应发生率方面无显著差异（>0.05）。2升PEG - ELS/Asc组肠道准备耐受率显著高于3升PEG - ELS组（93.3%对80.23%）（<0.05）。两组肠道准备前后肌酐、血钾、血钠和血氯水平均在正常范围内。此外，两种准备方案对糖尿病和便秘住院患者的肠道清洁效果均不如无这些情况的患者（<0.05）。
2升PEG - ELS/Asc用于住院患者结肠镜检查肠道准备的有效性和安全性不劣于3升PEG - ELS。对于糖尿病和便秘患者，两种肠道准备方案的清洁效果不太理想，在这方面需要进一步的临床研究。
