隔天分次口服复方聚乙二醇电解质散对老年便秘患者肠道准备效果的评价

陈礼鹏; 杜丽云; 郑培奋

doi:10.16766/j.cnki.issn.1674-4152.001769

隔天分次口服复方聚乙二醇电解质散对老年便秘患者肠道准备效果的评价

doi: 10.16766/j.cnki.issn.1674-4152.001769

浙江医院消化内科，浙江杭州 310012

基金项目:

浙江省医药卫生科技项目 2020KY397

详细信息

通讯作者:
郑培奋, E-mail: kuaidou09@163.com

中图分类号: R442.2 R616.5
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- 文章访问数: 363
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- 被引次数: 0
出版历程
- 收稿日期: 2020-03-12
- 网络出版日期: 2022-02-19

The effectiveness evaluation of polyethylene glycol electrolyte solution in bowel preparation in divided doses of two days for elderly constipation patients

Digestive System Department, Zhejiang Hospital, Hangzhou, Zhejiang 310012, China

摘要

摘要: 目的比较分析老年便秘患者结肠镜检查前1 d与检查当天分次服用复方聚乙二醇电解质散与检查前6 h一次性服用相同剂量的复方聚乙二醇电解质散的肠道准备效果及患者对不同方案的耐受情况。方法根据罗马Ⅳ便秘诊断标准，选取年龄在60~85岁的拟行无痛结肠镜检查的轻中度便秘患者150例，随机抽签分为A、B、C 3组，每组各50例。A组于检查前1 d下午15：00服用复方聚乙二醇电解质散1 L，检查前6 h再服用2 L；B组于检查前6 h服用复方聚乙二醇电解质散3 L；C组于检查前1 d晚上20：00服用复方聚乙二醇电解质散1 L，检查前6 h再服用2 L，3组患者的结肠镜检查时间点及检查前1 d饮食均相同。采用波士顿肠道准备量表(Boston bowel preparation scale，BBPS)评估肠道清洁度，记录结肠镜检查进镜时间，二者均由同一内镜医师单盲记录，患者对不同肠道准备方案的耐受性和不良反应采用问卷调查的方式获得。结果所有患者均较好地完成肠道准备及结肠镜检查，3组结肠镜进镜时间分别为(4.34±1.29)min、(4.59±1.32)min、(4.45±1.50)min, BBPS评分后肠道准备质量优良率分别为95.7%、93.9%、95.9%，差异无统计学意义(均P>0.05)；A组肠道准备耐受率为85.11%，C组为79.59%，均优于B组的62.22%;A组不良反应发生比例最低，为31.91%，C组为57.14%，B组最高，为93.88%，差异均具有统计学意义(均P < 0.05)。结论隔天分次口服复方聚乙二醇电解质散与常规结肠镜检查前6 h一次性服用相同剂量药物肠道准备效果无差别，但隔天服用对老年便秘患者具有更好的耐受性，不良反应更少，尤其是提前1 d下午服用，对睡眠影响少，值得临床推广。
- 老年便秘 /
- 复方聚乙二醇电解质散 /
- 隔天分次口服 /
- 肠道准备
Abstract: Objective To compare and analyze the bowel preparation effect and patient tolerance to different regimens of elderly constipation patients taking compound polyethylene glycol electrolyte powder in several doses 1 day before colonoscopy and on the same day as taking the same dose once 6 hours before colonoscopy. Methods According to the diagnostic criteria of Roman Ⅳ constipation, 150 mild to moderate constipation patients aged 60~85 years who were to undergo painless colonoscopy were selected and randomly divided into A, B and C groups, with 50 people in each group. Group A took 1 L of compound PEGYlated electrolyte powder at 15:00 1 day before the examination, and 2 L 6 hours before the examination. Group B received 3 L of compound PEGYlated electrolyte powder 6 hours before the examination. In group C, 1 L of compound PEGYlated electrolyte powder was taken at 20:00 1 day before the examination, and 2 L was taken 6 hours before the examination. The colonoscopy time point and diet of patients in the 3 groups were the same. Bowel cleanliness was assessed using the Boston Bowel Preparation Scale (BBPS), and scope-forward time was recorded. Both were recorded singly and blindly by the same endoscope physician. Patients' tolerance to different bowel preparation plans and adverse reactions were obtained through questionnaire survey. Results All patients completed bowel preparation and colonoscopy well. The average scope-forward time of the 3 groups were (4.34±1.29) min, (4.59±1.32) min, (4.45±1.50) min, and the good and good rates of bowel preparation quality after BBPS score were 95.7%, 93.9%, and 95.9%, respectively, with no statistically significant difference (all P>0.05). The bowel preparation tolerance rate in group A and Group C were 85.11% and 79.59%, both of which were better than 62.22% in group B. The incidence of adverse reactions in group A was the lowest (31.91%, 57.14% and 93.88%), and the results were statistically significant (all P < 0.05). Conclusion There is no difference in the effect of bowel preparation between the next day by several times of oral complex polyethylene glycol electrolyte powder and conventional colonoscopy one-time 6 hours before taking the same dose drugs, but the next day taking has better tolerance in patients with senile constipation, less adverse reaction, especially in the afternoon to take 1 day in advance and influence to sleep less, worth clinical promotion.
- Elderly constipation /
- Polyethylene glycol electrolyte solution /
- Divided doses of two days /
- Bowel preparation

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表 1 3组结肠镜检查患者一般资料比较(x ±s)

组别	例数	年龄(岁)	性别(男/女，例)
A组	47	73.60±5.00	20/27
B组	49	72.67±4.88	22/27
C组	49	71.63±4.46	21/28
统计量		2.026^a	0.064^b
P值		0.136	0.968
注：^a为F值，^b为χ²值。

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表 2 3组结肠镜检查患者肠道清洁情况比较(x ±s, 分)

组别	例数	右侧结肠BBPS评分	中段结肠BBPS评分	左侧结肠BBPS评分	BBPS评分总分
A组	47	2.07±0.80	1.60±0.83	2.11±0.90	6.72±1.10
B组	49	1.98±0.80	2.07±0.82	2.05±0.82	7.00±1.24
C组	49	2.03±0.84	2.05±0.79	1.89±0.76	6.71±1.27
F值		0.081	2.191	0.819	1.604
P值		0.922	0.116	0.443	0.163

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表 3 3组结肠镜检查患者肠道准备耐受情况比较[例(%)]

分组	例数	胃肠道耐受情况				耐受率(%)
分组	例数	1分	2分	3分	4分	耐受率(%)
A组	47	1(2.13)	6(12.77)	10(21.28)	30(63.83)	85.11(40/47)^b
B组	49	6(12.24)	13(26.53)	16(32.65)	14(28.57)	61.22(30/49)
C组	49	3(6.12)	7(14.29)	14(28.57)	25(51.02)	79.59(39/49)^b
统计量		14.310^a				8.106^c
P值		0.026				0.017
注：^a为Z值，^c为χ²值。与B组比较，^bP < 0.05。

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表 4 3组结肠镜检查患者肠道准备过程中不良反应发生情况比较[例(%)]

组别	例数	不良反应				影响睡眠
组别	例数	低血糖	腹痛	恶心	呕吐	影响睡眠
A组	47	2(4.26)^a	3(6.38)^a	7(14.89)^a	1(2.13)^a	2(4.26)
B组	49	11(22.45)	10(20.41)	17(34.69)	8(16.33)
C组	49	5(10.20)^a	3(6.12)^a	7(14.29)^a	3(6.12)^a	10(20.41)
χ²值		7.636	6.626	7.811	6.823	5.723
P值		0.022	0.036	0.020	0.033	0.017
注：与B组比较，^aP < 0.05。

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