乳果糖联合聚乙二醇方案对不同风险分层人群肠道准备效果的单中心随机对照研究  

Lactulose combined with polyethylene glycol for bowel preparation in patients of different risks:a single-center prospective randomized controlled trial

作　　者：张琎 肖勇[1] 印安宁[1] 曹卓[1] 李娇[1] 刘书中[1] 黄子殷 刘小娇 邬海燕 陈明锴[1] Zhang Jin;Xiao Yong;Yin Anning;Cao Zhuo;Li Jiao;Liu Shuzhong;Huang Ziyin;Liu Xiaojiao;Wu Haiyan;Chen Mingkai(Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院消化内科,430060

出　　处：《中华消化内镜杂志》2021年第12期980-984,共5页Chinese Journal of Digestive Endoscopy

基　　金：湖北省重点研发计划项目(2020BCB007)。

摘　　要：目的评估乳果糖联合聚乙二醇对于不同风险分层人群的肠道准备效果及安全性。方法纳入需行结肠镜检查的患者208例,其中肠道准备高风险患者108例和肠道准备低风险患者100例。利用区组随机化法,将肠道准备高风险患者分为A组(乳果糖+聚乙二醇组)54例和B组(聚乙二醇组)54例,将肠道准备低风险患者分为C组(乳果糖+聚乙二醇组)49例和D组(聚乙二醇组)51例,观察各组波士顿肠道准备评分、进镜及退镜时间、息肉及腺瘤检出率、不良反应等。结果在肠道准备高风险人群中,A组波士顿评分、腺瘤检出率[(6.35±1.15)分、46.3%]显著优于B组[(5.76±0.89)分、22.2%,P均<0.05],A组首次排便间隔时间显著短于B组[(1.20±0.85)h比(3.29±2.93)h,P<0.05]。A、B两组肠道准备充分率、息肉检出率、排便次数、不良反应发生率差异均无统计学意义。在肠道准备低风险人群中,C组患者首次排便间隔时间显著短于D组[(1.65±1.35)h比(3.42±2.64)h,P<0.05],不良反应的发生率明显低于D组(44.9%比64.7%,P<0.05)。C、D两组肠道准备充分率、波士顿评分、息肉及腺瘤检出率和排便次数差异均无统计学意义。结论在肠道准备高风险患者中,采用乳果糖联合聚乙二醇清肠方案效果优于传统聚乙二醇方案,能提高波士顿评分、腺瘤检出率,缩短首次排便间隔时间,且安全性好,优势明显。而对于肠道准备低风险患者,采用乳果糖联合聚乙二醇方案与传统聚乙二醇方案比较优势不明显。Objective To evaluate the efficacy and safety of lactulose combined with polyethylene glycol for bowel preparation before colonoscopy in patients of different risks.Methods A total of 208 patients undergoing colonoscopy were enrolled,including 108 high-risk and 100 low-risk patients.The high-risk patients were divided into group A(54 taking lactulose+polyethylene glycol)and group B(54 taking polyethylene glycol),and the low-risk patients were divided into group C(49 taking lactulose+polyethylene glycol)and group D(51 taking polyethylene glycol).The Boston bowel preparation score,cecal intubation time,withdrawal time,the detection rate of colonic polyps and adenoma,and the incidence of adverse reactions were observed.Results Among the high-risk patients,the Boston bowel preparation score and adenoma detection rate in group A[(6.35±1.15)scores,46.3%]were significantly higher than those in group B[(5.76±0.89)scores,22.2%,both P<0.05],and the first defecation interval in group A was significantly shorter than that in group B[(1.20±0.85)h VS(3.29±2.93)h,P<0.05].There was no significant difference in adequate bowel preparation rate,polyp detection rate,frequency of defecation or incidence of adverse reactions between group A and B.In the low-risk patients,the first defecation interval in group C was significantly shorter than that in group D[(1.65±1.35)h VS(3.42±2.64)h,P<0.05],and the incidence of adverse reactions was significantly lower than that in group D(44.9%VS 64.7%,P<0.05).There was no significant difference in adequate bowel preparation rate,Boston bowel preparation score,adenoma detection rate,polyp detection rate or frequency of defecation between group C and D.Conclusion For the high-risk patients,the effect of lactulose combined with polyethylene glycol for bowel cleansing is better than that of traditional polyethylene glycol in the improvement of the Boston bowel preparation score,adenoma detection rate,and the first defecation interval.For low-risk patients,lactulose combined with polyethylene gly

关 键 词：乳果糖 结肠镜检查 风险评估 肠道准备 

分 类 号：R574[医药卫生—消化系统]