作者： 丛雪1，韦键2，班燕1，高林英1，张静1

单位：1.首都医科大学附属北京友谊医院 消化分中心，北京 100050；2.首都医科大学附属北京友谊医院 护理部，北京 100050

Authors:  Cong Xue1，Wei Jian2，Ban Yan1，Gao Linying1，Zhang Jing1

Unit:  1.Digestive Sub Centers, Beijing Friendship Hospital of Capital Medical University, Beijing 100050, China；2.Department of Nursing, Beijing Friendship Hospital of Capital Medical University, Beijing 100050, China

摘要：

目的 肠道准备标准方案中3 L 复方聚乙二醇电解质溶液（polyethylene glycol electrolyte solution，PEG-ES）的服用方法为结肠镜检查前1晚服用1 L PEG-ES、检查当天早晨服用2 L PEG-ES。由于部分患者对于晨起服用2 L PEG-ES 的耐受性较差，本研究设计交换检查前1晚和当天早晨两次服用剂量的改良方案，旨在比较患者行改良方案与标准方案的肠道准备质量和耐受性差异。方法 本研究为单中心单盲随机对照试验，选取2022年1月1日至2023年4月30日在首都医科大学附属北京友谊医院行结肠镜下息肉切除的206例住院患者为研究对象，采用随机数字表法将其按1：1分为对照组（n=103）和试验组（n=103）。对照组执行标准方案，分别于结肠镜检查前1晚19:00服用1 L PEG-ES，结肠镜检查当天早4:00服用2 L PEG-ES。试验组则交换两次服用PEG-ES的剂量。观察两组患者的肠道准备质量评分、肠道气泡评分、结肠镜检查操作时间、新发息肉检出率、患者不良反应、睡眠质量及再次行同样肠道准备的意愿。结果 两组患者的性别、年龄、学历、体重指数的差异无统计学意义（P＞0.05），且均顺利完成肠道准备和结肠镜检查。试验组与对照组的肠道准备质量评分分别为（6.45±1.06）分和（6.61±1.36）分，差异无统计学意义（P=0.333），并且两组肠道准备充分率（P=0.372）、肠道气泡评分（P=0.191）、结肠镜检查操作时长（P=0.629）及新发息肉检出率（P=0.460）差异均无统计学意义，但两组患者不良反应发生率（P=0.009）、睡眠质量（P＜0.001）及再次行同样肠道准备的意愿（P＜0.001）的差异有统计学意义。结论 改良的PEG-ES剂量分配方案对于晨起服用PEG-ES耐受性较差、睡眠质量不佳的患者，具有可根据个人耐受度、服药习惯自主选择PEG-ES剂量分配方案的优点，改良方案具有安全性、可行性。

关键词： 复方聚乙二醇电解质溶液；结肠镜；肠道准备；剂量分配

Abstract：

Objective   The standard regimen for bowel preparation is a 3 L polyethylene glycol electrolyte solution (PEG-ES) given 1 L the night before the colonoscopy and 2 L in the morning of the colonoscopy. Since some patients could not tolerate 2 L PEG-ES in the morning, this study designed a modified regimen for exchanging two doses, in order to compare the quality and tolerance of bowel preparation between the modified regimen and the standard regimen. Method  This study is a single-center, prospective, single blind randomized trial. A total of 206 hospitalized patients who underwent colonoscopic polypectomy at Beijing Friendship Hospital of Capital Medical University from January 1 2022 to April 30 2023 and met the inclusion criteria, were selected for the study, and were divided into the control group (n=103) and the experimental group (n=103) using computerized randomization grouping (1:1). The control group implemented the standard regimen, 1 L of PEG-ES was taken at 19:00 one night before colonoscopy and 2 L of PEG-ES was taken at 4:00 in the morning on the day of colonoscopy, respectively; while the experimental group exchanged the dosage of PEG-ES for two times. Bowel preparation quality score, bowel bubble score, colonoscopy operation time, new polyp detection rate, patient adverse reactions, sleep quality and willingness to repeat the same bowel preparation were observed in both groups. Result  There were no statistically significant differences in the gender, age, education and body mass index between the two groups. Both groups completed bowel preparation and colonoscopy successfully. Total scores of Boston bowel preparation scale of two groups were (6.45±1.06) points and (6.61±1.36) points, respectively, with no statistical significance (P=0.333). No statistically significant differences were found between the two groups with rate of adequate bowel preparation(P=0.372), intestinal bubble score(P=0.191), colonoscopy operation duration(P=0.629) and detection rate of new polyps (P=0.460). However, there were statistically significant differences in incidence of adverse reactions(P=0.009) ,sleep quality (P＜0.001) and willingness to repeat the same bowel preparation(P＜0.001). Conclusion  The modified regimen has the advantages of independent choice of PEG-ES dose distribution regimen according to personal tolerance and medication habit for patients with poor tolerance to PEG-ES in the morning and poor sleep quality , and the modified regimen is safe and feasible.

Key Words:  Polyethylene glycol electrolyte solution; Colonoscopy; Bowel preparation; Dose distribution

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