伊托必利在改善便秘患者结肠镜前肠道准备中的作用  

Role of itopride in the improvement of bowel preparation before colon endoscopy examination inconstipated patients

作　　者：任玲[1] 顾立扬[1] 李海燕[1] 宋燕[1] 李晓波[1] 

机构地区：[1]上海交通大学医学院附属仁济医院消化内科上海市消化疾病研究所,200001

出　　处：《中华消化杂志》2013年第2期93-96,共4页Chinese Journal of Digestion

摘　　要：目的观察促胃肠动力药伊托必利在便秘患者结肠镜检查前肠道清洁中的作用。方法将需要结肠镜检查的有慢性便秘史的门诊连续病例115例纳入研究，根据肠道准备方案分为3组：A组39例，检查前6h服用标准剂量复方聚乙二醇电解质溶液；B组38例，口服A组洗肠液前30min口服150mg伊托必利；C组38例，检查前1d上午7点、上午12点、下午8点各口服150mg伊托必利，检查当天用药同B组。三组患者用药前后监测血压、心率及电解质等。观察各组患者肠道清洁度及不良反应。三组样本间两两比较采用单因素方差分析LSD检验；计数资料采用X^2检验。结果A、B组各有1例因结肠镜诊断为恶性肿瘤伴肠腔狭窄而被剔除，其余113例患者均完成全结肠检查。三组患者基线资料差异无统计学意义（P〉0．05）。C组患者各部分肠道及总体的清洁度评分均优于A、B组（总体清洁度评分：7．28±1．11比6．55±1．18、6．51±1．16，LSD检验，P均〈0．05）；C组排便次数亦多于A、B组（8．31±1．32比7．11±1．41、6．94±1．51，LSD检验，P均〈0．05）；三组肠道气泡，服药前后血压、心率、电解质，肠道准备的不适程度及不良反应发生率差异均无统计学意义（P均〉0．05）。结论结肠镜检查前1d及当天加用大剂量伊托必利能够安全有效地改善肠道准备效果。Objective To investigate the role of prokinetic agent itopride in colonic preparation before colonoscopy examination in patients with constipation. Methods A total of 115 outpatients with history of chronic constipation who requested colonoscopy were collected. According to colonic preparation proposal, patients were divided into three groups. Group A （39 cases） took standard dosage of PEG-E solution six hours before colonoscopy examination. Group B （38 cases） took 150 mg itopride 30 minutes before administration of lavage solution. Group C （38 cases） took itopride 150 mg at 7 am, 12 am and 8 pm the day before the examination and on the examination day took the same medicine as that of group ]3. The blood pressure, heart rate and blood electrolytes were monitored before and after taking medicine in the patients of three groups. Quality of colon cleansing of each group was observed and side effects were also observed. One-way analysis of variance （least significant difference, LSD） test was performed for pairwise comparisons among the three groups. Chi-square test was applied for count data. Results Both group A and group B excluded one patient because of malignant carcinoma with colon stricture under colonoscopy, and 113 patients completed the wholecolon examination. There was no significant difference in the baseline patients data of three groups. The colon cleaning score of group C （7.28il. 11） was higher than those of group A and B （6.55± 1.18 and 6.51±1.16, LSD test, both P〈0.05）. The frequency of bowel movements defecation of group C （8.31±1.32） was more than those of group A and group B （7. 11±1.41 and 6.94±1.51, LSD, test, both P（0.05）. There was no significant difference in terms of intestinal bubble scores, blood pressure, heart rate, blood electrolytes the uncomfortable degree of colonic preparation and rate of side effects of the three groups. Conclusion The colonic preparation can be safely and effectively improved by taking high dose of itopride one day before

关 键 词：结肠镜检查 手术前护理 聚乙烯二醇类 电解质 苯甲酰胺类 便秘 

分 类 号：R574.62[医药卫生—消化系统]