Different Methods For Bowel Preparation In Patients With Constipation Before Colonoscopy In Qinghai Region

Objective: Compared the quality of colonoscopy,the incidence of adverse reactions and the cost-effectiveness of three different kinds of bowel preparation programs in patients with constipation who were undergoing the colonoscopy in Qinghai region.To explore the application value of three kinds of bowel preparations for patients with constipation in colonoscopy.Methods: Selected 149 cases of hospitalized patients who with alimentary symptoms and diagnosis of constipation by colonoscopy in Qinghai affiliated hospital from November 2016 to November 2017,Collect general information and randomly divide it into 3 groups.Three options for bowel preparation,the control group was take polyethylene glycol-electrolyte lavage solution(PEG-ELS)separately;the test group needs take Mosapride Citrate Dispersible Tablets 3 days before colonoscopy ?and take PEG-ELS separately;the test group needs take Lactulose Orak Solution 1 ?day before colonoscopy and take PEG-ELS separately.We evaluated the colonoscopy quality,the incidence of adverse reactions and the economical effectiveness by comparing the quality of colonoscopy,the incidence of adverse reactions of 3 groups,and the incidence of adverse reactions and lesion detection rate in each subgroup.Results:1.The qualified rates of the three methods of intestinal cleaning were 58.54%,65.22% and 87.10%.By comparison,the effective rate of test group was ?higher than the other two groups,and with statistical difference(P<0.05).2.The cecum insertion rates of 3 groups were 90.24%,95.65% and 95.16% respectively,with no statistical difference between the groups(P>0.05).3.The colonoscopy operational time of the three groups were(9.76±0.65)mins,(9.68±0.64)mins and(9.78±0.49)mins;the colonoscopy withdraw time were(5.88±0.41)mins,(5.76±0.44)mins and(5.80±0.43)mins,with no statistical difference between those groups(P>0.05).4.The detection rate of intestinal diseases were 39.02%,63.04% and 61.29%,and the polyp detection rate were 24.39%,47.83% and 46.77%.The adenomas detection rate of 3 groups were 9.76%,26.83% and 27.42%;those rates of test group were higher than that of the control grou? p,with statistical difference(P<0.05).5.The incidence of adverse reaction of the 3 groups respectively were 46.34%,34.79% and 33.87%.Compared to the incidence of adverse reactions,there was no statistical difference between them(P > 0.05).6.The subgroups with satisfactory cleaning effect had a higher lesion detection rate and lower adverse reaction rate than the subgroups with unqualified cleaning effect,and with statistical difference(P<0.05).7.The cost-effectiveness ratio of 3 groups were 1.51,1.76 and 1.43.Conclusion: 1.It is safe for the patients with chronic constipation in Qinghai region to take PEG-ELS separately as bowel preparation program,but with a low effective rates of intestinal clean degree.2.Polyethlene glycol electrolyte dispresion(PEG)with Lactulose Orak Solution can improve the effective rates of intestinal clean degree and the detection rates of intestinal diseases apparently.The advantage of effection and price can be an ideal bowel preparation program for constipation patients.3.Those three bowel preparation programs: PEG,PEG plus mosapride and PEG plus Lactulose Orak Solution,have no difference in operational time,withdraw time and cecum insertion rates during colonoscopy.4.Those three bowel preparation programs: PEG,PEG plus mosapride,PEG plus Lactulose Orak Solution,have no difference in the incidence and the type of the adverse reactions.