利那洛肽联合聚乙二醇用于Child-Pugh评分A/B级肝硬化患者肠道准备的安全性及有效性研究  

Safety and Efficacy of Linalotide Combined with Polyethylene Glycol for Intestinal Preparation in Patients with Child-Pugh Grade A/B Cirrhosis.

作　　者：严永峰 马雨凡 张璐 张亚军 张霞 张琴 Yan Yongfeng;Ma Yufan;Zhang Lu(Department of Gastroenterology,The First People's Hospital of Liangshan Yi Autonomous Prefecture,Xichang,Sichuan 615000,China.)

机构地区：[1]凉山彝族自治州第一人民医院消化内科,四川西昌615000

出　　处：《四川医学》2024年第10期1121-1126,共6页Sichuan Medical Journal

基　　金：四川省医学会消化内镜专委会(捷祥)专项科研课题(编号:2021XHNJ12)。

摘　　要：目的探究利那洛肽联合聚乙二醇(PEG)用于肝硬化患者肠道准备的有效性及安全性。方法纳入2021年10月至2023年10月于我院就诊的需要结肠镜检查的Child-Pugh评分A/B级肝硬化患者共计254例。根据肠道准备方案分为观察组128例采用利那洛肽+2L聚乙二醇(2L PEG),对照组126例采用3L聚乙二醇组(3L PEG)。记录两组患者基线资料、肠道准备质量评价指标、肠镜检查质量评价指标、不良反应、肠道准备方案耐受度及接受度。结果219例完成肠道准备及肠镜检查,其中观察组114例,对照组105例,两组患者基线资料比较无统计学差异。两组患者肠道波士顿评分无统计学差异,观察组整体肠道准备合格率更高(83.3%vs.74.3%,P=0.101),进镜时间更短(P=0.016)。两组患者盲肠、回肠末端插管率及退镜时间差异无统计学意义,整体息肉发现率(50.0%vs.48.6%)及腺瘤发现率(30.7%vs.24.8%)相近。对照组多发病灶及病灶大于1 cm比例高于观察组,差异无统计学意义,但观察组右半结肠病变发现率更高(P=0.022)。观察组患者出现恶心(18.8%vs.33.3%),腹胀(21.9%vs.38.1%)的比例更低,患者耐受度更好,差异有统计学意义(P均<0.05)。观察组患者肠道准备方案接受度高于对照组(65.6%vs.51.6%),差异有统计学意义(P=0.023)。结论利那洛肽联合2L PEG方案用于肝硬化患者肠道准备安全且有效,可以作为肝硬化患者的一线肠道准备方案。Objective To explore the effectiveness and safety of linaclotide combined with polyethylene glycol(PEG)for bowel preparation in patients with liver cirrhosis.Methods From October 2021 to October 2023,total 254 patients with Child-Pugh grade A/B liver cirrhosis who required colonoscopy in our hospital were included.According to the intestinal preparation protocol,patients were divided into observation group(n=128)with linaclotide and 2L polyethylene glycol(2L PEG),and control group(n=126)with 3L polyethylene glycol group(3L PEG).The baseline data of patients,bowel preparation quality evaluation indicators,colonoscopy quality evaluation indicators,adverse reactions,tolerance and acceptance of the bowel preparation plan were recorded.Results 219 patients completed bowel preparation and colonoscopy,including 114 patients in the observation group and 105 patients in the control group.There was no statistical difference in the baseline data.There was no statistical difference in intestinal Boston score.The observation group had a higher overall intestinal preparation pass rate(83.3%vs.74.3%,P=0.101)and a shorter endoscopic time(P=0.016).There was no statistical difference in the intubation rate and endoscopy time in the cecum and terminal ileum.The overall polyp discovery rate(50.0%vs.48.6%)and adenoma discovery rate(30.7%vs.24.8%)were similar.Multiple lesions and the proportion of lesions larger than 1 cm in the control group was higher than that in the observation group.The difference was not statistically significant,but the discovery rate of right colon lesions was higher in the observation group(P=0.022).Patients in the observation group had lower rates of nausea(18.8%vs.33.3%)and abdominal distension(21.9%vs.38.1%),and patients had better tolerance,with statistically significant differences(P all<0.05).Patients in the observation group had higher acceptance of the intestinal preparation plan than the control group(65.6%vs.51.6%)with statistically significant difference(P=0.023).Conclusion Linaclotide combined wit

关 键 词：肝硬化 肠道准备 利那洛肽 聚乙二醇 有效性 安全性 

分 类 号：R575.2[医药卫生—消化系统]