| Objective: To investigate the differences of different doses of lactulose on bowel preparation before colonoscopy in patients with constipation,and to find the optimal formula of lactulose and polyethylene glycol.Methods: Information of 219 patients with chronic constipation(CC)who underwent colonoscopy in Changsha city first hospital from June 2018 to January 2020 were collected according to the inclusion and exclusion criteria,They were randomly divided into five groups and were given different options of bowel preparation.Patients in group A take four boxes of polyethylene glycol electrolyte powder(PEG-EP)for bowel preparation.Patients in group B1,B2,B3 and B4 take 3 boxes of polyethylene glycol electrolyte powder for bowel preparation,while group B2,B3 and B4 need to take 20ml/d,40ml/d and 60ml/d lactiose laxatives respectively two days earlier befor colonoscopy.The quality of bowel preparation,the detection rate of intestinal diseases and polyps,the incidence rate of adverse reactions and tolerance were used as evaluation indexes to find an optimal intestinal preparation plan.Results:1.The inserton time of group A,group B1,group B2,group B3 and group B4 were 8.98±0.77 minutes,9.16±1.02 minutes,8.96±0.95 minutes,6.97±1.03 minutes and 6.70±1.16 minutes,respectively.There were statistically differences(P<0.001).By caparation,the inserton time of group A,group B1 and group B2 were longer than that of group B3 and group B4,there were statistically differences in pairwise comparison(P<0.001).2.The ileocecal valve arrival rates of group A,B1,B2,B3 and B4 were 93.02%,92.86%,95.45%,100.00% and 100.00%,respectively,with no significant difference among these groups(P>0.05).3.There were statistical differences in the intestinal cleanliness among the five groups(P<0.001).By caparation,the intestinal cleanliness of group B3 and group B4 were better than that of group A,group B1 and group B2,with statistically significant difference(P<0.005).4.The detection rates of intestinal diseases in group A,B1,B2,B3 and B4 were 48.84%,38.10%,52.27%,80.43% and 81.82%,respectively,with statistically significant differences(P<0.001).The detection rates of intestinal diseases in group B3 and group B4 were all higher than those in group A,group B1 and group B2,with statistically significant differences(P?0.005).5.The polyp detection rates of group A,B1,B2,B3 and B4 were 34.88%,26.19%,40.91%,60.87% and 59.09%,respectively.The difference of polyp detection rate was statistically significant among these groups(P<0.05).The polyp detection rate of group B3 and group B4 was higher than that of group B1,and the difference was statistically significant(P<0.005).6.There was no significant difference in the incidence of acid-base imbalance and electrolyte disorder among the groups(P>0.05).7.The total incidence of adverse reactions in group A,B1,B2,B3 and B4 were 46.51%,9.52%,11.36%,17.39% and 31.82%,respectively,with statistically significant differences(P<0.001).The incidence of adverse reactions in group B1,B2 and B3 were compared with that in group A,and the difference was statistically significant(P<0.005).8.The tolerance rates of group A,group B1,group B2,group B3 and group B4 were 86.05%,97.62%,97.73%,95.65% and 93.18%,respectively,and there was no significant difference in tolerance between the groups(P >0.05).9.The willingness of receiving colonoscopy in group A,B1,B2,B3 and B4 were 72.09%,100.00%,95.45%,95.65%,84.09%,the difference was statistically significant(P<0.001).The willingness to undergo colonoscopy again in group A was lower than that in group B1,B2 and B3,with statistically significant differences(P<0.005).Conclusion:1.Polyethylene glycol combined with lactulose can improve the quality of bowel preparation,which is safe and effective.2.Taking 40ml/d lactulose 2 days earlier befor colonoscopy with Polyethylene glycol may be a ideal bowel preparation plan for patients with chronic constipation. |
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