低剂量聚乙二醇联合抗坏血酸方案对肠道黏膜损伤的影响

Evaluating mucosal injuries of low-volume PEG plus ascorbic acid regimen in bowel preparation

摘要:

目的 观察低剂量聚乙二醇联合抗坏血酸方案在结肠镜检查肠道准备中的效果、安全性及对肠 道黏膜损伤的影响。方法 选择需做结肠镜检查的患者500 例，随机分为两组，实验组给予低剂量聚乙二醇 联合抗坏血酸方案（A 组），对照组给予磷酸钠盐方案（B 组）行肠道准备。两组患者通过抽血检测血肌酐、 电解质，评估其安全性。术中观察肠道清洁度，评估肠道准备效果，同时观察肠道黏膜损伤情况，并行活检、 病理学检查。结果 A 组患者完成肠道准备233 例，完成肠镜检查226 例，B 组完成肠道准备238 例，完成肠 镜检查210 例，两组患者肠道清洁度情况无明显差异（P >0.05）。肠黏膜损伤及术后血肌酐、电解质紊乱等 情况低剂量聚乙二醇联合抗坏血酸组均优于磷酸钠盐组，差异有统计学意义（P <0.05）。结论 在肠道准备 效果上，两种方法都能达到检查要求，但抗坏血酸联合聚乙二醇组对肠黏膜损伤更小，且安全性更高。

Abstract:

Objective To study the bowel-cleansing efficacy, patient security and mucosal injury of lowvolume PEG plus ascorbic acid regimen. Methods Five hundred patients referred for colonoscopy were enrolled and randomly divided into two groups. Group A received low-volume PEG regimen, Group B received sodium phosphate (NaP) regimen for bowel preparation. Patients of the two groups drank solution 5 h before colonoscopies, serum creatinine and electrolyte were monitored at 5 h and 3 h before colonoscopies. The bowel-cleansing efficacy was rated during colonoscopy. All mucosal injuries observed during colonoscopy were biopsied and histopathologically reviewed. Results The patients of group A completed bowel preparation of 233 cases, completed colonoscopy 226 Cases, group B completed bowel preparation 238 cases, completed colonoscopy 210 cases. There was no significant difference in bowel cleansing between the groups (P > 0.05). Group A reported less incidence rate of the mucosal injuries than Group B. Group A reported better patient security than Group B at the same time. Conclusion Compared with sodium phosphate (NaP) regimen low-volume Polyethylene Glycol (PEG) plus ascorbic acid regimen exhibited equivalent bowel-cleansing efficacy and less incidence rate of the mucosal injuries and better patient security.