摘要目的 评估硫酸镁溶液分次口服法在老年人结肠镜检查肠道准备应用中的有效性及安全性.方法 纳入解放军总医院368例拟行结肠镜检查的老年患者,按随机数字法分为硫酸镁溶液分次口服组(分次组,178例)和硫酸镁溶液单次口服组(单次组,190例),比较两组患者一般资料、排便次数、波士顿肠道准备评分(BBPS)、病变检出率以及不良反应发生率、满意度等.结果 分次组总排便次数为(7.6±1.4)次,多于单次组的(6.6±1.5)次,P＜0.05;分次组检查当日完成肠道准备所需时长为(128.6±25.3) min,少于单次组的(165.4±29.7) min,P＜0.05;分次组肠道准备BBPS总评分为(8.09±0.67)分,优于单次组的(7.34±0.58)分,P＜0.05;分次组肠道息肉及微息肉(直径＜0.5 cm)检出率分别为41.0％(73/178)及28.7％(51/178),均高于单次组相应的30.5％(58/190)及19.5％(37/190),P均＜0.05.分次组有8例出现腹胀不适,无一例发生恶心、呕吐,2例因肠道准备不充分需进一步接受灌肠处理;单次组有27例出现腹胀不适,7例发生恶心、呕吐,13例因肠道准备不充分需进一步接受灌肠处理.分次组患者肠镜检查后有1例出现ST-T改变,但无动态变化,单次组有4例在检查过程中出现心电异常表现.分次组肠道准备满意率达97.8％ (174/178),高于单次组的91.6％ (174/190),P=0.001.结论 硫酸镁溶液分次口服的肠道准备方法在老年人中耐受性高,清洁效果好,不良反应发生率低,是老年人结肠镜检查肠道准备的理想选择.

abstractsObjective To evaluate the efficacy and safety of oral magnesium sulfate solution in split doses as bowel preparation in elderly patients undergoing colonoscopy.Methods A total of 368 elderly patients undergoing colonoscopy were enrolled at PLA General Hospital.The patients were randomly divided into magnesium sulfate solution orally in split doses group (group A,n=178) and single dose group (group B,n=190).Parameters including general information,defecation frequency,Boston bowel preparation score (BBPS),detection rate of lesions and adverse reactions.Results The frequency of defecations in group A was (7.6± 1.4),more than that in group B (6.6± 1.5) with statistical significance (P＜0.05).The duration of bowel preparation in group A was (128.6±25.3) min,shorter than that of group B (165.4±29.7) min (P＜0.05).The BBPS in group A was (8.09±0.67),better than that of group B (7.34±0.58) (P＜0.05).The detection rates of intestinal polyps and micropolyps (diameter＜0.5 cm) in group A were 73/178 (41.0％) and 51/178 (28.7％) respectively,compared with 58/190 (30.5％) and 37/190 (19.5％) in group B (both P＜0.05).In group A,8 patients reported adverse reactions as abdominal distension and discomfort.One patient had ST-T abnormality of electrocardiogram (ECG).No nausea or vomiting occurred,yet 2 cases needed enema for inadequate bowel preparation.Twenty-one cases in group B reported adverse events including 7 with nausea and vomiting.There were 13 patients treated with enema.Abnormal ECG was found in 4 patients in group B.The satisfaction rate of group A was 97.8％,higher than that of group B (91.6％) (P＜0.05).Conclusions The effect of bowel preparation of elderly patients with magnesium sulfate solution in split dose has a better tolerance,good cleaning effect and low incidence of adverse reactions.It is an ideal choice for the elderly to prepare colonoscopy.