Reiser J R, Rosman A S, Rajendran S K, Berner J S, Korsten M A
Section of Gastroenterology, Bronx VA Medical Center, New York, NY 10468, USA.
Gastrointest Endosc. 1995 May;41(5):481-4. doi: 10.1016/s0016-5107(05)80007-0.
Colonic lavage is a preferred preparation for colonoscopy although this type of preparation does not always result in optimal cleansing. We postulated that cisapride, a new prokinetic agent, might improve the cleansing of the colon and ameliorate patient discomfort. Of 84 patients undergoing colonoscopy, 41 were randomized (double-blind) to Golytely plus cisapride (10 mg per OS three times during the day before the procedure and one 10-mg dose on the morning of the procedure) and 43 to Golytely plus a placebo of identical appearance. The adequacy of the preparation was scored on a five-point grading scale for each anatomic segment and for the overall impression. A questionnaire was also used to assess each patient's symptoms during lavage. The mean overall preparation score in the cisapride group was 4.0, compared with 3.7 for the placebo group (p = .54). In the transverse colon, the mean preparation score was higher for the cisapride group (4.3 versus 3.8, p = .02). Differences in symptom scores between the two groups were not significant. In conclusion, the use of cisapride may improve visualization of the transverse colon, but it did not result in significant improvement in the overall preparation score. Changes in the dosage of cisapride should be further evaluated.
结肠灌洗是结肠镜检查的首选肠道准备方法，尽管这种准备方法并不总能达到最佳的清洁效果。我们推测，西沙必利这种新型促动力药物可能会改善结肠清洁程度并减轻患者不适。在84例接受结肠镜检查的患者中，41例被随机（双盲）分为服用聚乙二醇电解质散加西沙必利组（在检查前一天每天口服3次，每次10毫克，检查当天早晨再服10毫克），43例分为服用聚乙二醇电解质散加外观相同的安慰剂组。根据五分制评分量表对每个解剖部位以及总体印象的肠道准备充分程度进行评分。还使用问卷调查评估每位患者在灌洗过程中的症状。西沙必利组的总体准备平均评分为4.0分，而安慰剂组为3.7分（p = 0.54）。在横结肠部位，西沙必利组的平均准备评分更高（4.3分对3.8分，p = 0.02）。两组之间的症状评分差异不显著。总之，使用西沙必利可能会改善横结肠的视野，但总体准备评分并未显著提高。西沙必利的剂量变化应进一步评估。
