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聚乙二醇电解质灌洗液与传统机械肠道准备用于择期结肠手术的疗效比较:一项随机、前瞻性、盲法临床试验。

The efficacy of polyethylene glycol-electrolyte lavage solution versus traditional mechanical bowel preparation for elective colonic surgery: a randomized, prospective, blinded clinical trial.

作者信息

Fleites R A, Marshall J B, Eckhauser M L, Mansour E G, Imbembo A L, McCullough A J

出版信息

Surgery. 1985 Oct;98(4):708-17.

PMID:3901374
Abstract

This study documents the efficacy, safety and patient tolerance of GoLYTELY (Braintree Laboratories, Inc., Braintree, Mass.) an orally administered, nonexplosive, polyethylene glycol-electrolyte lavage solution, in elective colonic surgery. Fifty-three patients admitted for colonic surgery were randomized to either GoLYTELY or a traditional 3-day bowel preparation. Both groups received oral and perioperative antibiotics. Pre- and postpreparation weights, blood chemistries, and hematologic values were obtained. Postpreparation patient tolerance was assessed. During surgery the surgeon scored the bowel for the presence of retained air, fluid, or feces. Standardized semiquantitative aerobic and anaerobic bacterial counts were obtained from sigmoid aspirates. Postoperative infectious complications were recorded. Mechanical preparation with GoLYTELY resulted in a greater feeling of fullness, while the traditional preparation produced more hunger and abdominal cramping. The use of GoLYTELY resulted in better scores of overall quality and bowel appearance, reflecting a greater efficiency with which it removed air, fluid, and feces from the bowel. GoLYTELY also resulted in significantly fewer total aerobic and anaerobic organisms in sigmoid aspirates. This study suggests that GoLYTELY is a safe, well-tolerated, and effective orthograde lavage solution that has significant advantages over other mechanical preparations and should be considered the preparation of choice for elective colonic surgery.

摘要

本研究记录了口服非爆炸性聚乙二醇电解质灌洗液GoLYTELY(美国马萨诸塞州布伦特里市布伦特里实验室公司)在择期结肠手术中的疗效、安全性及患者耐受性。53例拟行结肠手术的患者被随机分为GoLYTELY组或传统的3天肠道准备组。两组均接受口服及围手术期抗生素治疗。记录准备前后的体重、血液化学指标及血液学指标。评估准备后患者的耐受性。手术过程中,外科医生对肠道内残留气体、液体或粪便的情况进行评分。从乙状结肠抽吸物中获取标准化的半定量需氧菌和厌氧菌计数。记录术后感染并发症。使用GoLYTELY进行机械性肠道准备会导致更强烈的饱腹感,而传统准备方法会产生更多饥饿感和腹部绞痛。使用GoLYTELY后,整体质量和肠道外观评分更高,这反映出其从肠道清除气体、液体和粪便的效率更高。GoLYTELY还使乙状结肠抽吸物中的需氧菌和厌氧菌总数显著减少。本研究表明,GoLYTELY是一种安全、耐受性良好且有效的顺行灌洗液,与其他机械性准备方法相比具有显著优势,应被视为择期结肠手术的首选准备方法。

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