新型口服硫酸盐溶液与小剂量聚乙二醇用于肠道准备的Meta分析

Meta analysis of novel oral sulfate solution versus low-dose polyethylene glycol for bowel preparation

摘要:

目的 比较新型口服硫酸盐溶液（OSS）和小剂量聚乙二醇（PEG）溶液对结肠镜检查质量的影响。方法 通过PubMed、Embase、Web of Science，搜索2000年1月－2020年12月发表的文章，使用Review Manager 5.4和Stata 12.0进行分析，比较新型OSS和小剂量PEG加维生素C（PEG + VC）溶液的肠道准备合格率、肠道准备优良率和不良反应发生率的差异。结果 6项研究共1 876名受试者符合纳入标准。在肠道准备合格率方面，OSS组和PEG + VC组比较，差异无统计学意义（93.4%和91.9%，RR＾ = 1.02，95%CI：0.99～1.04，P > 0.05），OSS组的肠道准备优良率高于PEG + VC组，差异有统计学意义（50.2%和42.6%，RR＾ = 1.18，95%CI：1.06～1.31，P < 0.05）。与PEG + VC组相比，OSS组恶心风险增加18.0%，差异有统计学意义（38.5%和32.6%，RR＾ = 1.18，95%CI：1.05～1.33，P < 0.05），呕吐风险增加1倍以上（10.8%和4.7%，RR＾ = 2.30，95%CI：1.63～3.23，P < 0.05）。Begg检验和Egger检验均未见明显发表偏倚。结论 使用新型OSS进行肠道准备，恶心和呕吐风险较低的患者有可能获得更好的肠道准备，因为与使用小剂量PEG溶液的患者相比，其增加了恶心和呕吐的风险。

Abstract:

Objective To compare novel oral sulfate solution (OSS) and low-dose polyethylene glycol (PEG) solution which can improve the quality of colonoscopy.Methods Search for articles published from January 2000 to December 2020 through PubMed, Embase, and Web of Science. Use Review Manager 5.4 and Stata 12.0 for analysis to compare novel OSS and low-dose PEG plus vitamin C (PEG + VC) solutions. The differences in adequate bowel preparation, good bowel preparation and side effects were compared.Results 1 876 subjects in 6 studies met the inclusion criteria. In terms of adequate bowel preparation, the difference between novel OSS group and PEG + VC group was not statistically significant (93.4% vs 91.9%, RR＾ = 1.02, 95%CI: 0.99~1.04, P > 0.05). The rate of good bowel preparation in OSS group was significant higher than that in PEG + VC group (50.2% vs 42.6%, RR＾ = 1.18, 95%CI: 1.06 ~ 1.31, P < 0.05). The risk of nausea in the OSS group increased by 18.0% compared with PEG + VC group, the difference was statistically significant (38.5% vs 32.6%, RR＾ = 1.18, 95%CI: 1.05~1.33, P < 0.05), and the risk of vomiting was more than doubled (10.8% vs 4.7%, RR＾ = 2.30, 95%CI: 1.63~3.23, P < 0.05). There were no obvious publication bias after Begg test and Egger test.Conclusion Patients with lower risk of nausea and vomiting with the new OSS were more likely to achieve good bowel preparation, because it increased the risk of nausea and vomiting compared with patients using a small dose of PEG solution.