A Prospective Audit of the Efficacy, Safety, and Acceptability of Low-volume Polyethylene Glycol (2 L) Versus Standard Volume Polyethylene Glycol (4 L) Versus Magnesium Citrate Plus Stimulant Laxative as Bowel Preparation for Colonoscopy
A Prospective Audit of the Efficacy, Safety, and Acceptability of Low-volume Polyethylene Glycol (2 L) Versus Standard Volume Polyethylene Glycol (4 L) Versus Magnesium Citrate Plus Stimulant Laxative as Bowel Preparation for Colonoscopy
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DOI：
10.1097/mcg.0b013e3182432162
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发表时间：
2012-08-01
影响因子：
2.9
通讯作者：
Mainie, Inder
中科院分区：
文献类型：
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作者：
Kelly, Nicholas Michael;Rodgers, Colin;Mainie, Inder
背景：高质量的视频结肠镜检查需要充分的肠道准备，以确保足够的手术完成率和息肉发现率。我们试图检查我们的做法，以确定在我们的患者中哪种肠道制剂最有效。目的：对低容量聚乙二醇(2-L电影制剂；Norgine PharmPharmticals)与标准容量聚乙二醇(4-L Klean-Prep；Norgine PharmPharmticals)与柠檬酸镁(Citramag；SanoChemia UK Ltd.)的有效性、安全性和可接受性进行前瞻性审计。地点：地区综合医院。患者：接受日间病例结肠镜检查的患者。干预措施：不适用。主要观察指标：所用制剂的总体清洁等级：患者依从性、味道和可接受性。方法：前瞻性审查患者服用肠道准备的经验和盲法结肠评分评估每个试验方案的肠道清洁。结果：共纳入258名患者(女性，138名；53.5%)，KleanPrep组91名(女性：45名，49.5%)，MoviPrep组86名患者(女性，45名；52.3%)，番泻叶/Citramag组81例(女性，44例，54.3%)。与其他两种方案相比，无法服用处方剂量的KleanPrep的患者明显更多(19.6%；P<；0.0001比MoviPrep；P<；0.0001比塞纳/Citramag)。共有45.65%的患者报告说KleanPrep的味道不好。这明显高于MoviPrep(10.47%；P=0.008)和SENA/Citramag(9.88%；P<；0.0001)。在3组(A级或B级)中，KleanPrep、MoviPrep和Senna/Citramag的总体清洁效率分别为73.9%、74.5%和86.5%。在本系列中，塞纳/西特拉玛在肠道清洁方面明显优于KleanPrep(P<；0.05)，并且与MoviPrep相比有更好的清洁效果(P=0.08)。限制：非随机试验。结论：总而言之，小剂量聚乙二醇单用(MoviPrep)和番泻叶/柠檬酸镁联合用药比大容量聚乙二醇组耐受性更好，番泻叶/柠檬酸镁具有更好的粘膜净化作用。
Background: High-quality video colonoscopy requires adequate preparation of the bowel to ensure both adequate procedure completion rates and polyp detection rates. We sought to examine our practice to determine which bowel preparation cleansed most effectively in our patients.Aim: A prospective audit of the efficacy, safety, and acceptability of low-volume polyethylene glycol (2-L Moviprep; Norgine Pharmaceuticals) versus standard volume polyethylene glycol (4-L Klean-Prep; Norgine Pharmaceuticals) versus magnesium citrate (Citramag; Sanochemia UK Ltd.) plus stimulant laxative as bowel preparation for colonoscopy.Setting: District General Hospital.Patients: Patients attending for day case colonoscopy.Interventions: Not applicable.Main Outcome Measures: Overall cleansing grades of preparations used: patient compliance, taste, and acceptability.Methods: A prospective audit of patient experience of taking bowel preparation and blinded colonic scoring assessment of bowel cleansing of each of the tested regimes.Results: A total of 258 (female, 138; 53.5%) patients were recruited, 91 in the KleanPrep group (F: 45, 49.5%), 86 patients in the Moviprep group (female, 45; 52.3%), and 81 in the Senna/Citramag group (female, 44; 54.3%). Significantly more patients were unable to take the prescribed dose of KleanPrep when compared with the other 2 regimes (19.6%; P < 0.0001 vs. Moviprep; P < 0.0001 vs. Senna/Citramag). A total of 45.65% of patients reported KleanPrep as tasting unpleasant. This was significantly more than both Moviprep (10.47%; P = 0.008) and Senna/Citramag (9.88%; P < 0.0001). The overall cleansing efficacy across the 3 groups (those with grades A or B) was 73.9%, 74.5%, and 86.5% for KleanPrep, Moviprep, and Senna/Citramag, respectively. In this series Senna/Citramag proved significantly better at bowel cleansing than KleanPrep (P < 0.05) and it showed a trend toward better cleansing when compared with Moviprep (P = 0.08).Limitations: Nonrandomized trial. Split-dosing regime for morning and afternoon lists may have confounded results.Conclusions: In summary, low-volume PEG (Moviprep) and Senna/Citramag combination were better tolerated than large volume PEG with Senna/Citramag providing superior mucosal cleansing.