目的

观察硫酸镁及磷酸钠盐应用于老年人结肠镜检查前肠道准备的安全性及有效性。

方法

选择解放军总医院第二医学中心254 例拟行结肠镜检查老年患者，随机分为硫酸镁组及磷酸钠盐组，比较两组患者一般信息、肠道准备完成情况、不良反应、病变检出率、患者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；硫酸镁组平均排便次数为（7.9±1.3）次，少于磷酸钠盐组（9.5±1.9）次，差异具有统计学意义（P＜0.05）。 硫酸镁组完成肠道准备时长为（123.6±23.7）min，磷酸钠盐组（138.2±25.5）min，差异具有统计学意义（P=0.016）。 硫酸镁组全结肠波士顿评分（BBPS）为（8.11±0.71），略高于磷酸钠盐组（7.98±0.69），差异无统计学意义（P=0.089）。 硫酸镁组肠道息肉及微息肉（直径＜5 mm）检出率分别为46/128（35.9%）及40/128（31.2%），分别较磷酸钠盐组38/126（30.1%）及31/126（24.6%）增高，差异均具有统计学意义（均P＜0.05）；硫酸镁组出现恶心、腹胀、腹痛等不适症状的发生率与磷酸钠盐无明显差别，但呕吐的发生率则较磷酸钠盐组降低，差异具有统计学意义（P＜0.05）。 硫酸镁组患者对肠道准备的满意率达95.3%，较磷酸钠盐组（96.8%）无明显差异。 磷酸钠盐组血钾及血磷异常发生率较硫酸镁组增高，而血镁异常发生率则在硫酸镁组更高，差异具有统计学意义（P＜0.05）。

结论

老年患者采用硫酸镁或磷酸钠盐分次口服方案实施肠道准备，服药依从性及耐受性好，清洁质量高，不良反应少，相对安全，适合在临床应用。

Objective

To observe the effectiveness and safety of Magnesium sulfate and sodium phosphate for bowel preparation before colonoscopy in elderly patients.

Method

A total of 254 elderly patients undergoing colonoscopy in the second medical center of PLA General Hospital were randomly divided into Magnesium sulfate group and sodium phosphate groups.The general information，completion of bowel preparation，adverse reactions，lesion detection rate，incidence of adverse reactions，patient satisfaction and abnormal changes of blood electrolyte after colonoscopy were compared between the two groups.

Result

There was no significant difference in age，gender，body mass index （BMI） between the two groups； After bowel preparation，the average number of bowel movements in the Magnesium sulfate group was （7.9±1.3） times，which was less than that in the sodium phosphate group （9.5±1.9） times，and the difference was statistically significant （P ＜0.05）.The average time required for the magnesium sulfate group to complete bowel preparation was （123.6±23.7） minutes，which was shorter than that of the sodium phosphate group （138.2 ± 25.5） minutes，and the difference was statistically significant （P=0.016）.The total score for Boston bowel preparation of Magnesium sulfate group was （8.11 ± 0.71），slightly higher than that of the sodium phosphate group （7.98 ± 0.69），and the difference was not statistically significant（P＜ 0.05）； The detection rates of bowel polyps and micro polyps （diameter＜5 mm） in the Magnesium sulfate group were 46/128 （35.9%） and 40/128 （31.2%），respectively，which were higher than those in the sodium phosphate group （38/126 （30.1%） and 31/126 （24.6%），and the differences were statistically significant （all P＜0.05）； The incidence of discomfort symptoms such as nausea，abdominal distension，and abdominal pain in the magnesium sulfate group was not significantly different from that in the sodium phosphate group，but the incidence of vomiting was lower than that in the sodium phosphate group，and the difference was statistically significant （P＜0.05）.The satisfaction rate of patients in the Magnesium sulfate group with intestinal preparation reached 95.3%，with no significant difference compared to the sodium phosphate group （96.8%）.The incidence of abnormal blood potassium and phosphorus in the sodium phosphate group was higher than that in the Magnesium sulfate group，while the incidence of abnormal blood Magnesium was higher in the Magnesium sulfate group，and the differences were statistically significant （P＜0.05）.

Conclusion

The use of magnesium sulfate or sodium phosphate in divided oral doses for bowel preparation in elderly patients has good medication compliance and tolerance，high hygiene quality，fewer adverse reactions，and is relatively safe，making it suitable for clinical application.