Church J M
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio, USA.
Dis Colon Rectum. 1998 Oct;41(10):1223-5. doi: 10.1007/BF02258217.
Polyethylene glycol gut lavage is an effective bowel preparation for colonoscopy. The quality of the preparation is not uniform however, and most studies report a rate of suboptimal cleansing of 10 percent or more. One of the possible reasons for a poor preparation is the length of time between the lavage and the examination. The aim of this study was to assess the effect of timing of polyethylene glycol gut lavage on the quality of the preparation achieved.
Patients referred for elective outpatient colonoscopy with afternoon appointments were randomized to take polyethylene glycol gut lavage either the same morning as their examination (Group 1) or the afternoon of the day before (Group 2). The colonoscopist was unaware of the preparation timing until after the examination was over. During the examination the endoscopist scored the quality of bowel preparation in the cecum, ascending colon, and transverse and left colon. Patient demographics and clinical data were recorded.
There were 157 patients in Group 1 (colonoscopy complete in 152 patients) and 160 in Group 2 (colonoscopy complete in 159 patients). The groups were similar in age and gender, indication for colonoscopy, and previous colonic surgery. Patients who drank gut lavage on the morning of their colonoscopy had a greatly better preparation in all areas of the colon than the patients who took their preparation the night before. In the cecum, 97 Group 1 patients had an excellent preparation (vs. 14 Group 2 patients), 45 had a good preparation (vs. 103 Group 2 patients), and 10 had a fair preparation (vs. 33 Group 2 patients). In the ascending colon, numbers of patients with excellent, good, fair, and poor results were 103, 45, 5, and 0 for Group 1 and 12, 107, 32, and 7 for Group 2. Results in the transverse and left colons were 102, 50, 5, 0 and 93, 55, 7, 2 for Group 1 and 15, 116, 27, 5 and 18, 114, 24, 3 for Group 2, respectively.
The timing of administration of polyethylene glycol-based gut lavage is a major determinant of the quality of the bowel preparation achieved.
聚乙二醇肠道灌洗是一种用于结肠镜检查的有效肠道准备方法。然而，准备质量并不一致，大多数研究报告次优清洁率为10%或更高。准备不佳的一个可能原因是灌洗与检查之间的时间长度。本研究的目的是评估聚乙二醇肠道灌洗时间对所达到的准备质量的影响。
被安排下午进行择期门诊结肠镜检查的患者被随机分为两组，一组在检查当天上午进行聚乙二醇肠道灌洗（第1组），另一组在检查前一天下午进行灌洗（第2组）。在检查结束前，结肠镜检查医生不知道准备时间。在检查过程中，内镜医生对盲肠、升结肠、横结肠和左结肠的肠道准备质量进行评分。记录患者的人口统计学和临床数据。
第1组有157名患者（152名患者完成结肠镜检查），第2组有160名患者（159名患者完成结肠镜检查）。两组在年龄、性别、结肠镜检查指征和既往结肠手术方面相似。在结肠镜检查当天上午进行肠道灌洗的患者，结肠各部位的准备情况均明显优于前一天晚上进行准备的患者。在盲肠，第1组97名患者准备极佳（第2组为14名），45名患者准备良好（第2组为103名），10名患者准备尚可（第2组为33名）。在升结肠，第1组准备极佳、良好、尚可和不佳的患者人数分别为103、45、5和0，第2组分别为12、107、32和7。横结肠和左结肠的结果，第1组分别为102、50、5、0和第2组分别为93、55、7、2；第1组分别为15、116、27、5和第2组分别为18、114、24、3。
基于聚乙二醇的肠道灌洗给药时间是所达到的肠道准备质量的主要决定因素。
