广西医学

目的探讨利那洛肽联合复方聚乙二醇（PEG）电解质散与西甲硅油在慢性便秘患者肠道准备中的应用效果。方法选择拟行结肠镜检查的慢性便秘患者240例作为研究对象，将患者随机分为A、B、C 3组，每组80例。A组患者采用复方PEG电解质散进行肠道准备，B组患者采用利那洛肽联合复方PEG电解质散进行肠道准备，C组患者采用利那洛肽联合复方PEG电解质散与西甲硅油进行肠道准备。比较3组患者的肠道清洁程度、祛泡效果、结肠镜检查时间、息肉检出率及不良反应发生率。结果B组和C组的盲肠和升结肠，结肠肝曲、横结肠和结肠脾曲，降结肠、乙状结肠和直肠3个肠段Boston肠道准备量表（BBPS）评分及总分高于A组（P＜0.05）；B组与C组在3个肠段的BBPS评分及总分上的差异无统计学意义（P＞0.05）。3组的祛泡效果比较，差异有统计学意义（P＜0.05），C组的祛泡效果优于A组和B组（P＜0.05），A组和B组祛泡效果的差异无统计学意义（P＞0.05）。3组患者的进镜时间和检查总时间由短到长依次为C组＜B组＜A组（P＜0.05），B组、C组的退镜时间短于A组（P＜0.05）。C组直径≤0.5 cm息肉检出率高于A组和B组（P＜0.05），A组和B组直径≤0.5 cm息肉检出率差异无统计学意义（P＞0.05）；3组患者直径＞0.5 cm息肉检出率比较，差异无统计学意义（P＞0.05）。C组的腹胀发生率低于A组（P＜0.05）。结论采用利那洛肽联合复方PEG电解质散与西甲硅油进行肠道准备可以提高慢性便秘患者的肠道清洁质量，减少肠道气泡量，缩短检查时间，提高直径≤0.5 cm息肉检出率，降低腹胀发生率。

ObjectiveTo investigate the application effect of linaclotide combined with Polyethylene Glycol (PEG) Electrolytes Powder and simethicone in bowel preparation for patients with chronic constipation. MethodsA total of 240 patients with chronic constipation who were prepared to undergo colonoscopic examination were selected as the research subjects, and they were randomly divided into groups A, B and C, with 80 cases in each group. Patients in group A received bowel preparation with PEG Electrolytes Powder, group B employed linaclotide combined with PEG Electrolytes Powder for bowel preparation, and group C received bowel preparation with linaclotide combined with PEG Electrolytes Powder and simethicone. The degree of intestinal cleanliness, effect of vesicles removing, colonoscopic examination duration, detection rate of polyps, and incidence rate of adverse reactions were compared between patients of the three groups. ResultsGroups B and C exhibited higher scores of the Boston Bowel Preparation Scale (BBPS) in 3 intestinal segments of cecum and ascending colon, hepatic flexura of colon, transverse colon and splenic flexura of colon, and descending colon, sigmoid colon and rectum, as well as a higher BBPS total score as compared with group A (P＜0.05), there was no statistically significant difference in BBPS scores of 3 intestinal segments and BBPS total score between group B and group C (P＞0.05). There was a statistically significant difference in the effect of vesicles removing between the three groups (P＜0.05), and group C yielded a superior effect of vesicles removing to compare with groups A and B (P＜0.05), there was no statistically significant difference in the effect of vesicles removing between group A and group B (P＞0.05). The entry time of colonoscopy and total examination duration of patients in the three groups were ordered from short to long as follows:group C＜group B＜group A (P＜0.05), and groups B and C interpreted shorter withdrawal time of colonoscopy as compared with group A (P＜0.05). The detection rate of polyps with diameter≤0.5 cm in group C was higher than that in groups A and B (P＜0.05), and there was no statistically significant difference in the detection rate of polyps with diameter≤0.5 cm between group A and group B (P＞0.05); moreover, no statistically significant difference in the detection rate of polyps with diameter＞0.5 cm was found between the three groups (P＞0.05). The incidence rate of abdominal distension in group C was lower than that in group A (P＜0.05). ConclusionEmploying linaclotide combined with PEG Electrolytes Powder and simethicone for bowel preparation can improve intestinal cleaning quality of patients with chronic constipation, reduce volume of intestinal vesicles, shorten examination duration, increase the detection rate of polyps with diameter≤0.5 cm, and decrease the incidence rate of abdominal distension.