摘要目的：探讨分次服用聚乙二醇（ PEG）及联合西甲硅油能否提高次日上午结肠镜检查的质量。方法将上午结肠镜检查的293例患者随机分为试验组（147例）和对照组（146例），试验组于检查前一天晚上口服PEG 2 L，当日早晨再口服1 L PEG和15 ml西甲硅油；对照组前一天晚上口服PEG 3 L，比较两组的肠道清洁度、腺瘤检出率和患者接受度。结果试验组波士顿肠道准备评分总分高于对照组（6?9±3?1比6?2±2?8，P＝0?032），右侧结肠清洁度优于对照组（2?6±1?0比2?0±0?9，P＝0?041）。两组腺瘤检出率差异无统计学意义（31?3％比29?5％，P＝0?796），但试验组小腺瘤（≤1?0 cm）检出率增高（64?5％比50?7％，P＝0?043），右半结肠腺瘤检出率有增高趋势（32?3％比18?6％，P＝0?075）。试验组肠道准备完成率高于对照组（98?6％比93?1％，P＝0?020），而恶心、呕吐发生率和拒绝再次检查的比例低于对照组（6?1％比13?7％，P＝0?033）。结论分次服用PEG及联合西甲硅油有助于提高清肠效果，增加腺瘤检出，并改善患者的依从性。

abstractsObjective To evaluate the performance of split?dosed polyethylene ( PEG) combined with simethicone in bowel preparation for morning colonoscopy. Methods A total of 293 patients scheduled for morning colonoscopic examination were randomly assigned to receive either split?dosed 3 liter of PEG ( 2 L in the evening before examination and 1 L in the morning of examination ) and 15 ml simethicone (Group A, n=147), or whole dose of 3 L PEG (the evening before examination) without simethicone ( Group B, n=146) . Bowel preparation quality, adenoma detection rate and patients′acceptance were com?pared between groups. Results Group A had higher Boston Bowel Preparation Scale in overall colon (6?9 ± 3?1 VS 6?2 ± 2?8, P=0?032) and better preparation quality of right?side colon ( 2?6 ± 1?0 VS 2?0 ± 0?9, P=0?041) . Adenoma detection rate was comparable between groups ( 31?3% VS 29?5%,P=0?796) , but group A detected more small adenomas (≤1?0 cm) ( 64?5% VS 50?7%, P=0?043) and showed a impro?ving trend for more right?side adenomas (32?3% VS 18?6%, P=0?075) than group B. More participants completed bowel preparation in group A than those in group B (98?6% VS 93?1%, P=0?020). Group A had fewer patients undergoing adverse events such as nausea and vomiting and fewer participants refusing to repeat colonoscopic examination (6?1% VS 13?7%, P=0?033) if necessary. Conclusion Split?dose PEG combined with simethicone can yield to better colon cleansing, detect more adenomas and ensure higher pa?tient compliance.