| Objective: To investigate the effects of four different PEG-ELS administration methods on the quality of intestinal preparation,the occurrence of adverse reactions and the tolerance of intestinal preparation in the elderly during colonoscopy,and to seek a more compliance and better tolerance optimization scheme for this special and large elderly population.Methods: With the approval of the Ethics Committee,elderly patients who planned to undergo colonoscopy,fully informed consent and signed informed in outpatient or inpatient from October 2020 to December 2021 will be enrolled.The patients were divided into group A,B,C and D in A single-blind,randomized controlled,prospective study.Group A received 2.25 L PEG-ELS on colonoscopy day,group B received 1.5 L PEG-ELS on colonoscopy day.Group C was given PEG-ELS 2.25 L combined with 200 m L magnesium sulfate solution on the day of examination.Patients in group D chewed xylitol free gum for 30 minutes after PEG-ELS 1.5 L on the day of examination.The quality of intestinal preparation,the occurrence of adverse reactions,the tolerance of patients,the willingness to repeat examination,the difference of lesion detection rate and intestinal preparation qualification rate in the four groups were compared.Chi-square test was used for the comparison of composition ratio or rates and one-way anova was used for the comparison of mean among the four groups,Kruskal-Wallis H rank-sum test was used for grade data(ctolerance).P< 0.05 was considered statistically significant.Results: A total of 408 elderly patients met the requirements of this study,including 104 in group A,93 in group B,124 in group C,and 87 in group D.The BBPS of groups A,C and D were higher than those of group B,the OBPS of groups A,C and D were lower than those of group B,the differences were statistically significant(P < 0.05).There was no significant difference in intestinal preparation score among groups A,C and D(P > 0.05).In terms of adverse reactions,the incidence of abdominal distention,nausea and vomiting in group D was lower than that in group A,B and C(P < 0.05).The comfort level(tolerance)of group D was higher than that of group A,B and C(P < 0.05).The proportion of group D willing to undergo colonoscopy again with the same intestinal preparation method was higher than that of group A,B and C(P <0.05).The differences were statistically significant.However,there were no significant differences in the qualified rate and lesion detection rate of intestinal preparation among the four groups(P > 0.05).Conclusions: 1.Four groups of different PEG-ELS intestinal preparation methods can complete good intestinal preparation,with high qualified rate,and meet the needs of intestinal preparation for clinical colonoscopy in the elderly.2.Isotonic solution of polyethylene glycol electrolyte powder(PEG-ELS)has a good effect on intestinal preparation before colonoscopy,but large doses of it may cause nausea,vomiting,abdominal pain,palpitation,dizziness,abdominal distension and other adverse reactions in elderly patients.3.The intestinal preparation plan of group A,C and D was superior to group B,and the intestinal preparation effect of group A,C and D was similar.However,the incidence of abdominal distention,nausea and vomiting in elderly patients in group D was significantly lower than that in group A,B and C.4.Low-dose polyethylene glycol electrolyte powder(PEG-ELS)combined with chewing gum is a safe,effective and well tolerated intestinal preparation method,which can be regarded as an optimization program with good compliance and tolerance in the elderly population,and is worthy of clinical reference. |
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