| Objective:To observe the effect of Lactulose Oral Solution after PEG-ELS on bowel preparation before colonoscopy,and to identify the related factors affecting the cleaning quality of bowel tract before colonoscopy..Methods:This study used prospective,random,endoscopic physician single-blind and placebo-controlled research methods.In December 2018 to January 2018,A total of 357 patients were screened for the criteria of inclusion,exclusion and elimination of patients in Shaanxi provincial People's hospital who were fitted with colonoscopy.All the patients included in the study were randomly divided into experimental group and control group,and both groups were randomly divided into 5 groups according to the interval between the last oral laxatives and colonoscopy(interval P-C),which were 4h,5h,6h,7h and 8h,respectively,and the patients determined the time of colonoscopy according to the method of drawing lots.The experimental group gave the PEG-ELS 2L+Lactulose Oral Solution 100mL on the day of colonoscopy,while the control group gave the PEG-ELS 2L+PEG-ELS(placebo)100mL.The results of colonoscopy in all patients were evaluated by using the Boston bowel preparation scale and the BS in the gut to evaluate the degree of bowel cleanliness.The researchers recorded the detection of lesions in colonoscopy(tumors,polyps,adenomas,etc.)and the size of the lesions,and the occurrence of adverse reactions in patients in colonoscopy;The researchers collected information on the sex,age,smoking,BMI index,education level,type of food consumed before examination and interval P-C in all colonoscopy patients for two Yuan Logistic regression analysis.Results:The experimental group,after PEG-ELS to add Lactulose Oral Solution,the rate of colon cleansing was 89.89%significantly higher than that of control group 79.89%,and the difference between the two groups was statistically significant(p<0.05).The BBPS in the experimental group was 7.21±1.44 significantly higher than that of the control group 6.53±1.59,and the difference between the two groups was statistically significant(p<0.05),in which the BBPS of the left colon,descending colon and right colon were 2.39±0.63,2.63±0.53,2.19±0.61,respectively,were higher than the control group 2.10±0.63,2.48±0.61 and 1.95±0.68,and the difference between the two groups of BBPS was statistically significant(p<0.05).The bubble score in the experimental group was 1.10±1.17 significantly lower than that of the control group2.55±1.47,and the difference between the two groups was statistically significant(p<0.05).The Bubble Scores of ascending colon,descending colon,transverse colon,sigmoid colon and cecum were 0.33±0.59,0.20±0.47,0.16±0.44,0.19±0.48 and 0.21±0.46 were lower than those in control group 0.64±0.71,0.49±0.65,0.42±0.63,0.53±0.63,0.46±0.63,the difference between the two groups of Bubble Scores is statistically significant(p<0.05).The BBPS at intervals P-C of 4h,5h,6h,7h and 8h in the experimental group were 7.68±1.21,7.44±1.05,7.05±1.34,6.90±1.62 and 6.80±1.88 higher than those in the control group 6.95±1.31,6.72±1.53,6.65±1.81,6.34±1.61 and 5.75±1.53,among which the BBPS of the experimental group were significantly higher than those in the control group at intervals of 4h,5h and 8h,and the differences between the two groups were statistically significant(p<0.05).The Bubble Scores of4h,5h,6h,7h and 8h in the experimental group were 0.90±0.20,0.72±0.82,0.85±1.21,1.42±1.09 and 1.80±1.40 significantly lower than those in control group 2.08±0.11,2.23±0.97,2.18±1.59,2.91±1.34,3.68±1.89,the difference between the two groups of Bubble Scores at intervals of 4h,5h,6h,7h and 8h was statistically significant(p<0.05).The detection of colon lesions:the total detection rate of colon lesions in the experimental group was 64.0%higher than that of control group 53.1%,and the difference between the two groups was statistically significant(p<0.05);The detection rate(ADR)of adenomas in the experimental group was 25.8%higher than that of control group 14.5%,and the difference between the two groups was statistically significant(p<0.05),and the detection rate of minor lesions(diameter?5mm)in the experimental group 11.8%was significantly higher than that in the control group 3.4%,the difference between the two groups was statistically significant(p<0.05).The time of withdrawal of 6.23±1.56min in the experimental group was significantly shorter than that of Group7.22+2.35min,and the difference between the two groups was statistically significant(p<0.05).The total incidence of adverse reactions in the experimental group was 16.9%lower than that of control group 20.1%.two-dollar logistic regression analysis of the sex,age,smoking,BMI index,education level and interval P-C indicators for all patients included in the study and completed colonoscopy showed:Bowel preparation method(?~2=9.711,P=0.002,OR=0.341,CI=1.173~0.670),BMI value(?~2=15.219,P=0.000,OR=0.813,CI=0.732~0.902)and interval P-C(?~2=11.753,P=0.001,OR=0.668,CI=0.530~0.841)are independent factors that affect the quality of bowel cleaning in colonoscopy.Conclusions:PEG-ELS on the basis of the addition of Lactulose Oral Solution more than the single use of PEG-ELS:1.Effectively improve the cleaning quality of bowel preparation;2.Extend the maintenance time of bowel cleaning to achieve the effect of high efficiency and slow release;3.Improve the detection rate of adenomas and minor lesions and shorten the time of withdrawal during colonoscopy;4.two-dollar logistic regression analysis showed that bowel preparation methods,BMI values and interval P-C were independent related factors for bowel preparation quality,and it was shown that the improvement of bowel preparation methods,preventive weight reduction before enteroscopy and appropriate shortening of interval P-C could improve the pass rate of bowel cleanliness,So that the quality of bowel preparation to achieve satisfactory results. |
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