Randomized controlled trial: Standard versus supplemental bowel preparation in patients with Bristol stool form 1 and 2.
Randomized controlled trial: Standard versus supplemental bowel preparation in patients with Bristol stool form 1 and 2.
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随机对照试验：布里斯托大便 1 型和 2 型患者的标准肠道准备与补充肠道准备
DOI：
10.1371/journal.pone.0171563
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Li Y
中科院分区：
文献类型：
--
作者：
Li Y;Jia X;Liu B;Qi Y;Zhang X;Ji R;Yu Y;Zuo X;Li Y
背景：布里斯托大便类型1和2是肠道准备不足的重要预测指标。目的评价补充剂对Bristol大便类型1、2患者肠道清洁质量的影响，并探讨以Bristol大便类型量表为指导进行量身定制肠道准备的可行性。方法3所三级医院随机选择1~7岁的布里斯托大便患者，分别给予L聚乙二醇凝胶2粒(A组)或比沙地10 mg加L聚乙二醇凝胶2粒(B组)，大便3~7粒采用L聚乙二醇凝胶2粒(C组)进行肠道准备。主要终点是整个结肠的充分肠道修复率。次要终点为结肠分离段的适宜肠道准备率、息肉检出率(PDR)、耐受性、可接受性、睡眠质量和依从性。结果700例患者随机入组。按方案分析，B组准备成功率显著高于A组(88.7%vs.61.2%，p<；0.001)，与C组相似(88.7%vs.85.0%，p=0.316)。B组的PDR显著高于A组(43.2%vs.25.7%，p<；0.001)。B组和C组的可接受性明显高于B组和C组。结论10 mg双沙可定加2 L聚乙二醇乙二醇酯能显著改善Bristol粪便类型1和2的患者的肠道准备质量和肠道顺应性。Bristol粪便形态评分可作为结肠镜检查前的量身定制肠道准备的简便有效的指导。
Background Bristol stool form 1 and 2 is an important predictor of inadequate bowel preparation. Aim To evaluate the efficacy of supplemental preparation in bowel cleansing quality among patients with Bristol stool form 1 and 2, as well as the feasibility of tailored bowel preparation guided by Bristol stool form scale. Methods Patients with Bristol stool form 1 and 2 from 3 Chinese tertiary hospitals randomly received either 2 L PEG-ELP (group A) or 10 mg bisacodyl plus 2 L PEG-ELP (group B); patients with Bristol stool form 3 to 7 received 2 L PEG-ELP (group C) for bowel preparation. The primary endpoint is the rate of adequate bowel reparation for the whole colon. The adequate bowel preparation rate for separate colon segments, the polyp detection rate (PDR), tolerability, acceptability, sleeping quality and compliance were evaluated as secondary endpoints. Results 700 patients were randomized. In per-protocol analysis, patients in group B attained significantly higher successful preparation rate than group A (88.7% vs. 61.2%, p<0.001) and similar with group C (88.7% vs. 85.0%, p = 0.316). The PDR in group B was significantly higher than group A (43.2% vs. 25.7%, p<0.001). Acceptability was much higher in group B and C. Conclusions 10 mg bisacodyl plus 2 L PEG-ELP can significantly improve both bowel preparation quality and PDR in patients with Bristol stool form 1 and 2. Bristol stool form scale may be an easy and efficient guide for tailored bowel preparation before colonoscopy.