乳果糖肠道准备优化方案的前瞻性随机对照试验

A prospective randomized controlled trial on the optimization protocol of lactulose intestinal preparation

摘要:

目的 对比分析乳果糖与复方聚乙二醇电解质散（PEG）在肠道准备中的应用效果，以建立优化肠道准备的新方案。方法 采用前瞻性随机对照试验，纳入2023年1月－2024年6月于江苏大学附属高淳医院（南京市高淳人民医院）拟行结肠镜检查的患者300例，随机分为乳果糖组（n = 150）和PEG组（n = 150）。评估两组患者肠道清洁度［波士顿肠道准备量表（BBPS）评分和肠道气泡评分（BBS）］、大便总次数、末次大便性状、结肠腺瘤检出率（ADR）、不良反应发生率和口感评分。结果 乳果糖组BBPS总分明显高于PEG组，BBS明显低于对照组，差异均有统计学意义（P < 0.05）。乳果糖组大便总次数多于PEG组，末次大便呈水样便占比明显低于PEG组，口感评分高于PEG组，不良反应发生率低于PEG组，差异均有统计学意义（P < 0.05）；两组患者ADR比较，差异无统计学意义（P > 0.05）；肠道准备不足与患者体脂率呈正相关（r = 0.265，P < 0.05）。结论 乳果糖用于肠道准备的效果与复方PEG接近，但乳果糖组的肠道视野更好，气泡更少，且口感较复方PEG好。值得临床推广应用。

Abstract:

Objective To compare and analyze the application effects of lactulose and compound polyethylene glycol electrolyte powder (PEG) in intestinal preparation, in order to establish a new scheme for optimizing intestinal preparation.Methods A prospective randomized controlled trial was conducted. 300 patients scheduled for colonoscopy from January 2023 to June 2024 were included and randomly divided into the lactulose group (n = 150) and the PEG group (n = 150). The intestinal cleanliness [Boston bowel preparation scale (BBPS) score and bowel bubble score (BBS)], the total number of bowel movements, the characteristics of the last stool, the detection rate of adenoma detection rate (ADR), the incidence of adverse reactions, and taste score of the two groups of patients were evaluated.Results The total BBPS score of the lactulose group was significantly higher than that of the PEG group, and the BBS score was significantly lower than that of the PEG group. The differences were statistically significant (P < 0.05). The total number of bowel movements in the lactulose group was more than that in the PEG group, the proportion of watery stools in the final stool was significantly lower than that in the PEG group, the taste score was higher than that in the PEG group, and the incidence of adverse reactions was lower than that in the PEG group. The differences were all statistically significant (P < 0.05). There was no statistically significant difference in ADR between the two groups of patients (P > 0.05). Insufficient intestinal preparation was positively correlated with the body fat percentage of patients (r = 0.265, P < 0.05).Conclusion The effect of lactulose in intestinal preparation is close to that of compound PEG, but lactulose has a better intestinal field of vision, fewer bubbles, and a better taste than compound PEG. It is worthy of clinical promotion and application.