Lawrance J A, Massoud T F, Creasy T S, Shatwell W, Mason A, Nolan D J
Department of Radiology, John Radcliffe Hospital, Headington, Oxford.
Clin Radiol. 1994 Jan;49(1):35-7. doi: 10.1016/s0009-9260(05)82911-3.
Sodium picosulphate (Picolax) is widely used for bowel preparation prior to colonic investigation or surgery. The most troublesome side effect reported is headache, which has been thought to be due to dehydration. In a prospective randomized study we investigated the incidence of adverse effects in patients given Picolax prior to barium enema examination, and assessed the incidence of adverse effects with different oral fluid regimens. A total of 197 outpatients were allocated to one of five fluid regimens on the day prior to the enema: (a) 4 pints of Dioralyte (glucose and electrolyte solution); (b) 4 pints of half-strength Dioralyte; (c) 4 pints of water; (d) 6 pints of water; and (e) free fluids. In a questionnaire, 36% of patients had no headache (graded 0/5), while 38% had a significant headache (graded 3/5 or greater). Sixteen per cent had significant abdominal pain, 42% had dry mouths, 43% thirst and 34% tiredness or irritability. There was no correlation between headache and fluid regimen. Furthermore, we have found no evidence of dehydration. None of the five fluid regimens was shown to offer any advantage, and we therefore recommend that patients be allowed to drink according to thirst when taking Picolax.
比沙可啶钠（聚乙二醇电解质散）在结肠检查或手术前的肠道准备中被广泛使用。报道中最麻烦的副作用是头痛，一直被认为是由脱水引起的。在一项前瞻性随机研究中，我们调查了在钡灌肠检查前服用聚乙二醇电解质散的患者的不良反应发生率，并评估了不同口服补液方案下的不良反应发生率。在灌肠前一天，共有197名门诊患者被分配到五种补液方案中的一种：（a）4品脱的口服补液盐（葡萄糖和电解质溶液）；（b）4品脱半强度的口服补液盐；（c）4品脱水；（d）6品脱水；以及（e）自由饮水。在一份问卷中，36%的患者没有头痛（0/5级），而38%的患者有严重头痛（3/5级或更高）。16%的患者有严重腹痛，42%的患者口干，43%的患者口渴，34%的患者疲倦或易怒。头痛与补液方案之间没有相关性。此外，我们没有发现脱水的证据。五种补液方案均未显示出任何优势，因此我们建议患者在服用聚乙二醇电解质散时根据口渴程度饮水。
