在真实世界中使用2 L和3 L聚乙二醇电解质溶液进行肠道准备的效果比较  

Efficacy of 2 L versus 3 L polyethylene glycol in bowel preparation:a real-world study

作　　者：李蕉君 谭贤豪 张宸 刘一锋 姜琳[2] 孙晓滨[2] 单晶[2] LI Jiaojun;TAN Xianhao;ZHANG Chen;LIU Yifeng;JIANG Lin;SUN Xiaobin;SHAN Jing(School of Clinical Medicine,North Sichuan Medical College,Nanchong,Sichuan;Department of Gastroenterology,Chengdu Third People’s Hospital,Chengdu,Sichuan;College of Clinical Medicine,Southwest Medical University,Luzhou,Sichuan,China)

机构地区：[1]川北医学院临床医学院,四川南充 [2]成都市第三人民医院消化内科,四川成都 [3]西南医科大学临床医学院,四川泸州

出　　处：《陆军军医大学学报》2025年第3期255-261,共7页Journal of Army Medical University

基　　金：成都市第三人民医院科研项目(2023PI21);成都市第三人民医院临床研究项目(CSY-YN-01-2023-049)。

摘　　要：目的比较在真实世界中2 L及3 L聚乙二醇电解质溶液(polyethylene glycol,PEG)的肠道准备效果。方法本研究为真实世界环境中单中心的队列研究,研究对象为2023年5-10月在成都市第三人民医院消化内科接受结肠镜检查并使用2 L或3 L PEG进行肠道准备的患者。根据纳排标准,3 L组共纳入3700例,2 L组共纳入4684例。主要结果指标是根据波士顿肠道准备评分(Boston bowel preparation score,BBPS)计算的肠道准备充分率;次要结果包括BBPS分数、息肉检出率(polyp detection rate,PDR)、耐受性、依从性和不良反应。结果3 L组的肠道准备充分率为94.35%,高于2 L组的91.29%(P<0.001);BBPS总分为(6.92±1.06)分,高于2 L组的(6.81±1.14)分(P<0.001)。2组的PDR无统计学差异(P=0.073)。2组患者PEG完成率(P=0.810)、按要求进行低渣饮食(P=0.094)及服用二甲硅油(P=0.072)差异均无统计学意义。3 L组的呕吐率(4.5%vs 3.2%,P=0.002)、腹部不适率(5.0%vs 3.9%,P=0.011)和睡眠障碍率(18.0%vs 14.6%,P<0.001)高于2 L组。结论在真实世界,2 L PEG是一种安全有效的肠道准备方案。Objective To compare the efficacy of 2 L and 3 L polyethylene glycol(PEG)electrolyte solution for bowel preparation in a real-world setting.Methods A real-world,single-center cohort study was conducted on the individuals undergoing colonoscopy in Department of Gastroenterology of Chengdu Third People’s Hospital between May and October 2023.Based on our inclusion and exclusion criteria,they were given 2 L(n=4684)and 3 L(n=3700)PEG electrolyte solution for bowel preparation.The primary outcome indicator was the adequacy of bowel preparation by Boston bowel preparation score(BBPS).Secondary outcome indicators included the BBPS score,polyp detection rate(PDR),tolerability,compliance,and incidence of adverse events.Results The adequacy rate of bowel preparation was 94.35%in the 3 L group,significantly higher than that of the 2 L group(91.29%,P<0.001).The 3 L group obtained a higher BBPS score then the 2 L group(6.92±1.06 vs 6.81±1.14,P<0.001).But there was no statistical difference in the PDR between the 2 groups(P=0.073).And the rate of PEG completion(P=0.810),administration of low residue diet as required(P=0.094)or use of dimethicone(P=0.072)were comparable between the 2 groups.However,the incidences of vomiting(4.5%vs 3.2%,P=0.002),abdominal discomfort(5.0%vs 3.9%,P=0.011)and sleep disturbance(18.0%vs 14.6%,P<0.001)were obviously higher in the 3 L group than the 2 L group.Conclusion In a real-world setting,2 L PEG is a considerably safe and effective regimen for bowel preparation.

关 键 词：聚乙二醇电解质溶液 肠道准备 比较效益研究 真实世界 

分 类 号：R195.1[医药卫生—卫生统计学] R574[医药卫生—卫生事业管理] R981.2[医药卫生—公共卫生与预防医学]