切换至 "中华医学电子期刊资源库"

中华胃肠内镜电子杂志 ›› 2021, Vol. 08 ›› Issue (02) : 68 -71. doi: 10.3877/cma.j.issn.2095-7157.2021.02.005

所属专题: 文献

教学园地

硫酸镁溶液不同口服方法在老年人肠道准备中的应用效果及安全性分析
葛伏林1, 吴文娟1, 王鸣1, 徐杰1, 胡倩1, 董晓宇1, 万军1,()   
  1. 1. 100853 北京,解放军总医院第二医学中心消化内科
  • 收稿日期:2021-04-22 出版日期:2021-05-15
  • 通信作者: 万军
  • 基金资助:
    军队保健专项课题(15BJZ45)

Application effect and safety analysis of different oral methods of magnesium sulfate solution in bowel preparation for colonscopy in elderly patients

Fulin Ge1, Wenjuan Wu1, Ming Wang1, Jie Xu1, Qian Hu1, Xiaoyu Dong1, Jun Wan1,()   

  1. 1. Department of Gastroenterology, The Second Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
  • Received:2021-04-22 Published:2021-05-15
  • Corresponding author: Jun Wan
引用本文:

葛伏林, 吴文娟, 王鸣, 徐杰, 胡倩, 董晓宇, 万军. 硫酸镁溶液不同口服方法在老年人肠道准备中的应用效果及安全性分析[J]. 中华胃肠内镜电子杂志, 2021, 08(02): 68-71.

Fulin Ge, Wenjuan Wu, Ming Wang, Jie Xu, Qian Hu, Xiaoyu Dong, Jun Wan. Application effect and safety analysis of different oral methods of magnesium sulfate solution in bowel preparation for colonscopy in elderly patients[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2021, 08(02): 68-71.

评估硫酸镁溶液不同口服方法在老年人结肠镜检查前肠道准备中的效果、安全性及对血电解质的影响。

方法

选取解放军总医院第二医学中心564例拟行结肠镜检查老年患者,随机分为硫酸镁溶液分次口服组和单次口服组,比较两组患者一般资料、肠道准备完成情况、病变检出率、不良反应发生率、满意度及检查后血电解质异常情况等。

结果

两组病例在年龄、性别、体重指数(BMI)等无明显差别;分次组肠道准备波士顿总评分为(8.01±0.67),优于单次组(7.35±0.58),差异具有统计学意义(P<0.05);分次组肠道息肉及微小息肉(直径<0.5 cm)检出率分别为103/282(36.5%)及81/282(28.7%),较单次组87/282(30.9%)及64/282(22.7%)增高,差异均具有统计学意义(均P<0.05)。分次组有15例出现腹胀不适症状、3例出现腹痛、13例发生恶心、2例出现呕吐、5例因肠道准备不充分需要进一步补充灌肠。单次组则有36例出现腹胀不适、5例出现腹痛、27例发生恶心、7例出现呕吐、16例因肠道准备不充分需要进一步补充灌肠。分次组肠道准备满意率达97.9%,高于单次组(90.4%),差异具有统计学意义(P<0.05)。两组检查后血钠、血钾、血镁及血钙的紊乱发生率均较低,且在两组间无明显差异(均P>0.05)。

结论

硫酸镁溶液分次口服法较单次口服法肠道准备效果好,不良反应发生率更低,对血电解质并无明显影响,适合在老年人群中应用。

Objective

To evaluate the efficacy and safety of different oral methods of Magnesium sulfate solution for bowel preparation before colonoscopy in elderly patients and its influence on blood electrolytes.

Method

A total of 564 elderly patients undergoing colonoscopy in the second medical center of PLA General Hospital were randomly divided into two groups: magnesium sulfate solution in split dose group and in single douse group. The general information, bowel preparation, lesion detection rate, incidence of adverse reactions, satisfaction and abnormal changes of blood electrolyte were compared between the two groups.

Result

There was no significant difference in age, gender, body mass index (BMI) between the two groups; The total score for Boston bowel preparation in the split dose group was (8.01 ± 0.67), which was better than that in the single dose group (7.35 ± 0.58), and the difference was statistically significant (P< 0.05); the detection rates of intestinal polyps and micro polyps (diameter < 0.5 cm) in the split dose group were 103/282 (36.5%) and 81/282 (28.7%), which were higher than 87/282 (30.9%) and 64/282 (22.7%) in the single dose group, the differences were statistically significant (both P< 0.05). There were 15 cases of abdominal distension, 3 cases of abdominal pain, 13 cases of nausea and 2 cases of vomiting in the split dose group, and 5 cases needed further enema due to inadequate bowel preparation. In the single dose group, 36 cases had abdominal distension, 5 cases had abdominal pain, 27 cases had nausea, 7 cases had vomiting, and 16 cases needed further enema due to inadequate bowel preparation. The satisfaction rate of bowel preparation in the split dose group was 97.9%, which was higher than that in the single group (90.4%), and the difference was statistically significant (P< 0.05). The incidence of electrolyte abnormality was lower in both groups, and there was no significant difference between the two groups (P> 0.05).

Conclusion

Compared with single oral administration, magnesium sulfate solution oral in split dose has better bowel preparation effect, lower incidence of adverse reactions and no significant effect on blood electrolytes, so it is suitable for elderly patient.

表1 波士顿肠道准备评分标准(BBPS)
表2 两组患者一般资料的比较(±s)
表3 两组患者肠腔各段BBPS评分比较(±s)
表4 两组患者部分病变检出情况对比
表5 两组间不良反应及满意度的比较
表6 两组检查后血电解质紊乱发生率比较
[1]
Calderwood AH, Jacobson BC. Comprehensive validation of the Boston bowel preparation scale [J]. Gastrointest Endosc,2010,72(4): 686-692.
[2]
葛伏林,万军. 老年人结肠镜检查肠道准备的策略及特点[J/CD]. 中华腔镜外科杂志(电子版)2017,6(3): 182-184.
[3]
中华消化内镜学会.中国消化内镜诊疗相关肠道准备指南(草案)[J].中华消化内镜杂志,2013,30(9): 481-483.
[4]
Horton N, Garber A, Hasson H,et al. Impact of single-vs split-dose low-volume bowel preparations on bowel movement kinetics,patient inconvenience,and polyp detection: a prospective trial[J]. Am J Gastroenterol,2016,111(9): 1330-1337.
[5]
Riegert M, Nandwani M. Enhancing the quality of colonoscopy through split-dose bowel preparation [J]. Gastroenterol Nurs,2014, 37(2): 148-154.
[6]
Martel M, Barkun AN, Menard C,et al. Split-Dose preparations are superior to day-before bowel cleansing regimens: a meta-analysis [J]. Gastroenterology,2015,149(1): 79-88.
[7]
Park JH, Kim SJ, Hyun JH,et al. Correlation between bowel preparation and the adenoma detection rate in screening colonoscopy [J]. Ann Coloproctol,2017,33(3): 93-98.
[8]
Hassan C, Bretthauer M, Kaminski MF,et al. Bowel preparation for colonoscopy: European society of gastrointestinal endoscopy (ESGE) guideline[J]. Endoscopy,2013,45(2): 142-150.
[9]
Lawrance IC, Willert RP, Murray K. Bowel cleansing for colonoscopy: prospective randomized assessment of efficacy and of induced mucosal abnormality with three preparation agents[J]. Endoscopy,2011,43(5): 412-418.
[1] 王文华, 吴周全, 恽惠方, 王志萍. 经鼻右美托咪定在老年患者无痛肠镜检查中的应用[J]. 中华普通外科学文献(电子版), 2021, 15(05): 344-348.
[2] 李世红, 牛钦王, 刘雁军, 张元川, 刘展. 术前未行肠道准备对择期结直肠手术影响的探讨[J]. 中华普通外科学文献(电子版), 2021, 15(04): 278-281.
[3] 李肆柱, 贾恒, 张溪, 訾维, 王文刚, 孙鹏进, 杨威. 机械性肠道准备在结直肠手术的临床应用价值研究[J]. 中华普外科手术学杂志(电子版), 2020, 14(05): 464-467.
[4] 方红燕, 刘晓昌, 方家旭. 腹部按压联合综合护理在腹壁造口旁疝患者肠镜检查中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 625-629.
[5] 陈佳楠, 陈海鹏, 王玲玲, 刘正, 刘骞. 首荟通便胶囊在右半结肠切除手术肠道准备中的作用研究[J]. 中华结直肠疾病电子杂志, 2021, 10(05): 476-481.
[6] 杨龙宝, 赵刚, 安苗, 秦赟, 薛琼, 王进海, 董蕾. 联合无痛胃肠镜检查患者的肠道准备策略[J]. 中华结直肠疾病电子杂志, 2021, 10(03): 278-283.
[7] 顾君君, 赵子夜, 韩文军, 吴琴, 王苗, 陈佳, 杨婷, 于恩达. 日间病房结直肠息肉切除患者的肠道准备质量现状调查[J]. 中华结直肠疾病电子杂志, 2020, 09(06): 576-580.
[8] 孔绘敏, 王秀勤, 梁海. 硫酸镁钠钾口服液与复方聚乙二醇电解质散对患者肠道清洁的对比研究[J]. 中华消化病与影像杂志(电子版), 2023, 13(04): 259-261.
[9] 杨晓金, 李婷, 蔡波尔, 吴云林, 陈平, 杨翠萍. 五个家族性腺瘤性息肉病家系分析[J]. 中华消化病与影像杂志(电子版), 2022, 12(04): 220-223.
[10] 吕小燕, 宋建华, 王莉, 方衍锋. 肠道准备对无痛胃镜黏膜清晰度和安全性的影响[J]. 中华消化病与影像杂志(电子版), 2020, 10(02): 66-69.
[11] 于晓欢, 路璐, 赵振峰, 谢长访, 熊英. 利那洛肽胶囊联合低剂量聚乙二醇电解质散用于结肠镜肠道准备的可行性与安全性[J]. 中华胃肠内镜电子杂志, 2022, 09(03): 121-125.
[12] 叶淑君, 刘阳, 马连君. 肠道准备与结肠息肉检出率的研究进展[J]. 中华胃肠内镜电子杂志, 2022, 09(02): 104-107.
[13] 张静洁, 江振宇, 汤泊夫, 武勇, 孟宪梅. 乙状结肠二次进镜对于腺瘤性息肉检出率影响的研究[J]. 中华胃肠内镜电子杂志, 2022, 09(02): 82-85.
[14] 邵佩, 皮壮, 钟媛, 王楠, 王丽波. 注水法在婴幼儿结肠镜检查中的应用[J]. 中华胃肠内镜电子杂志, 2022, 09(01): 25-29.
[15] 中华医学会消化内镜学分会儿科协作组, 中国医师协会内镜医师分会儿科消化内镜专业委员会. 中国儿童消化内镜诊疗相关肠道准备快速指南(2020,西安)[J]. 中华胃肠内镜电子杂志, 2021, 08(01): 1-12.
阅读次数
全文


摘要