COLONOSCOPIC BOWEL PREPARATIONS - WHICH ONE - A BLINDED, PROSPECTIVE, RANDOMIZED TRIAL
COLONOSCOPIC BOWEL PREPARATIONS - WHICH ONE - A BLINDED, PROSPECTIVE, RANDOMIZED TRIAL
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DOI：
10.1007/bf02054117
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发表时间：
1995-06-01
影响因子：
3.9
通讯作者：
AGUILAR, PS
中科院分区：
文献类型：
--
作者：
GOLUB, RW;KERNER, BA;AGUILAR, PS
在过去的十年里，在诊断和治疗结肠和直肠之前，口服、正交法、聚乙二醇-电解质灌洗液(PEG-EIS)一直是首选的肠道清洁方案。这些解决方案的体积大且难于接受，可能会导致令人不安的副作用和患者依从性差。目的：这项研究是为了确定结肠镜检查前的各种结肠清洗方法中哪一种可以在保持相似或改善的有效性和安全性的同时提供更好的患者接受性。方法：329名接受择期动态结肠镜检查的患者前瞻性地随机分为三种肠道准备方案之一。第1组接受41例PEGEIS治疗(n=124)。第2组在聚乙二醇ELs的基础上，口服胃复安(n=99)。第3组：口服磷酸钠(n=106)。所有组按年龄和性别平均配对。结果：91%的患者完成了所接受的准备工作。16%的患者在肠道准备过程中遭受了严重的睡眠损失。当比较三组时，在恶心、呕吐、腹部痉挛、肛门刺激或制剂质量方面的评估没有差异。与其他制剂相比，口服磷酸钠的耐受性更好。更多患者完成准备(P<0.001)。主诉腹胀的患者较少(P<0.001)。更多的患者愿意重复他们的准备(P<0.02)。此外，研究发现，磷酸钠的价格比任何一种聚乙二醇ELS制剂都要便宜四倍。结论：所有方案均有相同的疗效。添加甲氧氯普胺对腹部症状和肠道准备没有影响。口服磷酸钠制剂比其他任何一种制剂更便宜，耐受性更好，更有可能完成。
For the past decade peroral, orthograde, polyethylene glycol-electrolyte lavage solutions (PEG-EIS) have been the preferred bowel-cleansing regimens before diagnostic and therapeutic procedures on the colon and rectum. The large volume and unpalatibility of these solutions may lead to troubling side effects and poor patient compliance. PURPOSE: This study was undertaken to determine which of various colon-cleansing methods before colonoscopy would provide greater patient acceptance while maintaining similar or improved effectiveness and safety. METHODS: Three hundred twenty-nine patients undergoing elective ambulatory colonoscopy were prospectively randomized to one of three bowel preparation regimens. Group 1 received 41 of PEG-EIS (n = 124). Group 2, in addition to PEG-ELS, received oral metoclopramide (n = 99). Group 3 received oral sodium phosphate (n = 106). All groups were evenly matched according to age and sex. RESULTS: Ninety-one percent of all patients completed the preparation received. Sixteen percent of patients suffered significant sleep loss with a bowel preparation. When comparing the three groups, there was no difference in the assessment of nausea, vomiting, abdominal cramps, anal irritation, or quality of the preparation. Compared with other preparations, oral sodium phosphate was better tolerated. More patients completed the preparation (P less than or equal to 0.001). Fewer patients complained of abdominal fullness (P less than or equal to 0.001). More patients were willing to repeat their preparation (P less than or equal to 0.02). Also, sodium phosphate was found to be four times less expensive than either of the PEG-ELS preparations. CONCLUSION: All regimens were found to be equally effective. Abdominal symptoms and bowel preparation were not influenced by the addition of metoclopramide. The oral sodium phosphate preparation was less expensive, better tolerated, and more likely to be completed than either of the other preparations.