优化饮食限制下2.0 L与1.5 L聚乙二醇结肠镜肠道准备质量的比较：一项多中心随机对照研究

Comparison of the quality of bowel preparation for colonoscopy between 2.0 L and 1.5 L polyethylene glycol under optimized dietary restrictions: a multicenter randomized controlled study

摘要:

目的 比较优化饮食限制后，2.0 L聚乙二醇（polyethylene glycol，PEG）和1.5 L PEG用于肠道准备的效果。 方法 2024年5月5—30日在海军军医大学第一附属医院（n=57）、复旦大学附属华东医院（n=30）和北部战区总医院（n=30）3个医院开展随机对照研究。各个中心接受检查性或治疗性结肠镜的合格受试者检查前1 d均采取低渣特医食品作为饮食限制，受试者按随机化表分配至A组（特医饮食+2.0 L PEG）和B组（特医饮食+1.5 L PEG）。观察指标包括肠道准备完成率、肠道准备合格率、肠道准备优秀率、肠道准备评分、受试者满意度、肠道准备方案愿意重复率、内镜医师满意度以及不良反应发生率。 结果 最终纳入A组60例，B组57例。A组和B组受试者基线特征比较差异无统计学意义（P>0.05）。A组的肠道准备合格率［81.7%（49/60）比64.9%（37/57），χ²=4.21，P=0.040］和内镜医师满意度［88.3%（53/60）比70.2%（40/57），χ²=5.91，P=0.015］显著高于B组。肠道准备完成率、肠道准备优秀率、肠道准备评分、受试者满意度、肠道准备方案愿意重复率和不良反应发生率比较差异无统计学意义（P>0.05）。结论 在优化饮食限制基础上，2.0 L PEG方案比1.5 L PEG方案更合理。

Abstract:

Objective To compare bowel preparation quality between 2.0 L and 1.5 L polyethylene glycol (PEG) regimens with optimized dietary restrictions. Methods This study was a randomized controlled trial conducted in three hospitals: the First Affiliated Hospital of Naval Medical University (n=57), Huadong Hospital Affiliated to Fudan University (n=30), and General Hospital of Northern Theater Command (n=30) from May 5th to 30th, 2024. Participants consumed food for special medical purpose one day before examination or therapeutic colonoscopy and were randomized to receive either 2.0 L PEG (group A) or 1.5 L PEG (group B). Outcomes included the completion rate of bowel preparation, the adequate/excellent bowel preparation rate, Boston bowel preparation scale scores, the subject/endoscopist satisfaction, the willingness to repeat the preparation regimen, and incidence of adverse events. Results A total of 60 subjects in group A and 57 in group B were included. There was no significant difference in baseline characteristics between the two groups (P>0.05). The adequate bowel preparation rate [81.7% (49/60) VS 64.9% (37/57), χ²=4.21, P=0.040] and endoscopist satisfaction [88.3% (53/60) VS 70.2% (40/57), χ²=5.91, P=0.015] in group A were significantly higher than those in group B. There were no significant differences in bowel preparation completion rates, the excellent bowel preparation rate, the bowel preparation score, subject satisfaction, willingness to repeat the preparation regimen, or incidence of adverse events (P>0.05). Conclusion When combined with optimized dietary restrictions, 2.0 L PEG provides superior bowel preparation quality compared with 1.5 L PEG.