中国南方结直肠癌平均风险人群低剂量聚乙二醇方案肠道准备质量调查  

A multi-center cross-sectional study on the bowel cleansing quality wiht single-dose low-volume polyethylene glycol solution in colorectal cancer screening for average-risk adults in Southern China

作　　者：于新 朱藜果 吴建维[3] 雷平光 王丽萍[5] 崔毅[2] 张盛洪[2] YU Xin;ZHU Li-guo;WU Jian-wei;LEI Ping-guang;WANG Li-ping;CUI Yi;ZHANG Sheng-hong(Division of Gastrointestinal Endoscopy,Hui Ya Hospital of The First Affiliated Hospital,Sun Yat-sen University,Huizhou 516080,Guangdong,China;不详)

机构地区：[1]中山大学附属第一医院惠亚医院镜检中心,广东惠州516080 [2]中山大学附属第一医院消化内科,广东广州510080 [3]深圳市宝安区松岗人民医院消化内科,广东深圳518105 [4]深圳市宝安区人民医院内镜中心,广东深圳518101 [5]佛山市第二人民医院消化内科,广东佛山528099

出　　处：《广东医学》2019年第22期3152-3156,共5页Guangdong Medical Journal

基　　金：广东省特支计划科技创新青年拔尖人才

摘　　要：目的探讨单次口服低剂量聚乙二醇溶液在中国南方结直肠癌平均风险人群结肠镜检查前肠道准备质量现状,为改进肠道准备方案、提高结肠镜检查质量提供依据。方法采用横断面研究方法,前瞻性纳入2015—2018年在中国南方地区5家医院以低剂量聚乙二醇方案作肠道准备的结直肠癌平均风险患者,以波士顿评分系统(Boston Bowel Preparation Scale,BBPS)进行肠道准备质量评分,结合受检者结肠腺瘤检出率(adenoma detection rate,ADR)和不良反应发生情况,评估该肠道准备方案在结直肠癌筛查中的有效性和适用性。结果共纳入284例男性和174例女性,男、女受检者中位BBPS均为6(5,7),仅有59.2%男性和69.5%女性获得合格或以上的肠道准备效果。全年龄男性ADR(20.4%)高于女性(11.5%),且男性左半结肠ADR更高(P<0.05)。年龄<45岁组ADR(8.4%)低于45岁≤年龄<50岁组(18.6%)及年龄≥50岁组(29.8%)(P<0.05),45岁≤年龄<50岁组及年龄≥50岁组之间ADR差异无统计学意义(P>0.05)。年龄≥50组右半/左半结肠ADR均高于年龄<45岁组(P<0.05)。大部分受检者可以接受低剂量聚乙二醇溶液的口感(96.5%男性、96.0%女性)、气味(99.3%男性、97.7%女性)和剂量(86.6%男性、90.2%女性),主要不良反应表现为胃肠道不适,全部受检者均未出现严重不良反应。结论中国南方地区结直肠癌平均风险人群使用单次口服低剂量聚乙二醇溶液进行肠道准备质量有待提高,临床上需通过调整新的方案以提高肠道准备质量,从而保证结直肠癌筛查效率。Objective To analyzed the quality of bowel preparation induced by orally taken single-dose low-volume polyethylene glycol(PEG)solution in colorectal cancer screening for average-risk adults in Southern China,therefore seeking to improve the effectiveness of colonic cleansing before colonoscopy.Methods This multi-center,prospective,cross-sectional study evaluated the effectiveness and tolerability of single-dose low-volume PEG induced bowel preparation with BBPS,ADR and prevalence of adverse effects in the colonoscopy screening for average-risk adults in 5 Southern China hospitals from 2015 to 2018.Results A total of 284 males and 174 females included in the study had similar median BBPS of 6(5,7),among whom 59.2%of males and 69.5%of females acquired adequate bowel preparation(BBPS≥6).The ADR of males(20.4%)was statistically significantly higher than that of females(11.5%),along with higher left-sided ADR(P<0.05).The ADR of subjects aged<45 years(8.4%)was significantly lower than subjects aged between 45 and 49(18.6%)and aged≥50(29.8%)(P<0.05).Most subjects are able to tolerate the taste(96.5%of males;96%of females),smell(99.3%of males;97.7%of females)and dosage(86.6%of males;90.2%of females)of low-volume PEG solution.The most prevalent adverse effects were gastrointestinal disorders and no severe adverse effect was reported.Conclusion The effectiveness of single-dose low-volume PEG solution in inducing colonic cleansing before colorectal cancer screening for average-risk adults in Southern China needs to be improved.

关 键 词：聚乙二醇 低剂量 结直肠癌平均风险人群 肠道准备 多中心 

分 类 号：R574.6[医药卫生—消化系统] R605[医药卫生—内科学]