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目的 比较四种结肠镜检查前肠道准备方案的临床效果.方法 选取行结肠镜检查的患者620例为研究对象,采用随机数字表法将患者分为A、B、C、D四组,每组各155例,分别给予硫酸镁、复方聚乙二醇、硫酸镁联合西甲硅油、复方聚乙二醇联合西甲硅油进行肠道准备.在结肠镜检查时对患者的肠道准备效果、息肉检出情况、不良反应发生情况以及肠道准备的影响因素进行统计分析.结果 A、B、C、D四组肠道清洁程度良好率分别为84.52％、91.61％、85.81％、94.19％,A、C组肠道清洁程度良好率明显低于B、D组,差异均有统计学意义(x2=4.32,P ＜0.05;x2=7.63,P＜0.05;x2 =4.10,P＜0.05;x2=6.06,P＜0.05);A、B、C、D四组肠道无泡率分别为86.45％、87.74％、92.26％、90.96％,C、D组肠道祛泡效果明显优于A、B组(x2 =4.17,P＜0.05;x2 =4.76,P＜0.05;x2 =5.02,P＜0.05;x2 =4.23,P＜0.05);A、B、C、D四组息肉检出率分别为35.4％、36.8％、51.6％、54.2％,与A、B组相比,C、D组的息肉检出率更高(x2 =8.24,P＜0.05;x2=11.04,P＜0.05;x2 =6.95,P＜0.05;x2 =9.53,P＜0.05);A、C组的不良反应发生率(21.3％、19.4％)高于B、D组(7.8％、6.5％)(x2=11.86,P＜0.05;x2 =14.95,P＜0.05;x2 =9.18,P＜0.05;x2 =11.95,P＜0.05);结肠镜检查次数、便秘、服药与检查时间间隔、肠道准备方案、不良反应是肠道准备效果的主要影响因素.结论 复方聚乙二醇电解质散的肠道准备效果优于硫酸镁,安全性高,联用西甲硅油可提高肠道准备效果和息肉检出率,肠道准备效果受多种因素影响,在临床工作中需注意.

Objective To investigate the clinical effects of four different bowel preparation methods for colonoscopy.Methods 620 patients examined by coloscopy were randomized into four groups (group A,B,C and D),with each group in 155 cases.Group A received magnesium sulfate.Group B received compound polyethylene glycol.Group C received magnesium sulfate combined with simethicone.Group D received compound polyethylene glycol combined with simethicone.The quality and influencing factors,the detection of polyps and adverse events were compared between the four groups.Results The good bowel cleaning rate of group A,B,C and D were respectively 84.52％,91.61％,85.81％ and 94.19％.The good bowel cleaning rates of group A and C were higher than those of group B and D (x2 =4.32,P ＜ 0.05;x2 =7.63,P ＜ 0.05;x2 =4.10,P ＜ 0.05;x2 =6.06,P ＜ 0.05.).The bubble free rate of group A,B,C and D were 86.45 ％,87.74％,92.26％ and 90.96％.The bubble free rates of group C and D were higher than those of group A and B (x2 =4.17,P ＜ 0.05;x2 =4.76,P ＜ 0.05;x2 =5.02,P ＜ 0.05;x2 =4.23,P ＜ 0.05).The polyp detection rates of group A,B,C and D were 35.4％,36.8％,51.6％ and 54.2％.Group C and D showed higher quality of foam eliminating and detection rate of polyps as compared with group A and B (x2 =8.24,P ＜0.05;x2 =11.04,P ＜0.05;x2 =6.95,P ＜0.05;x2 =9.53,P ＜0.05).The incidence of adverse reactions of group A and C (21.3％ and 19.4％) were higher than group B and D (7.8％ and 6.5％) (x2 =11.86,P＜0.05;x2 =14.95,P ＜0.05;x2 =9.18,P ＜0.05;x2 =11.95,P ＜0.05).The frequency of colonoscopy,constipation,medication and examination time interval,bowel preparation methods and adverse events were the the influ ence factors of bowel preparation.Conclusion The quality of bowel preparation of compound polyethylene glycol electrolyte powder is better than magnesium sulfate with high security.Treatment of combination with simethicone can improve bowel preparation quality.Many factors can affect bowel preparation,which need to be paid attention to.