特殊人群结肠镜检查前肠道准备质量的影响因素

Factors Influencing the Quality of Intestinal Preparation before Colonoscopy in Special Population

摘要: 针对老年人、糖尿病、慢性便秘、炎症性肠病、肝硬化、慢性肾脏病等特殊人群结肠镜检查前肠道准备质量的影响因素的相关研究进行综述，指出通过长时间低纤维饮食、分次剂量方案和肠道准备结束后5小时内结肠镜检查等策略，可提高老年人的肠道清洁成功率。此外，尽管对于其他难以进行肠道准备的患者，没有特别推荐的肠道准备方法，但临床证据表明，1 L PEG加抗坏血酸制剂与炎症性肠病患者更高的肠道清洁成功率相关。严重肾功能不全(肌酐清除率 < 30 mL/min)的患者应使用等渗高容量PEG溶液进行肠道清洁。目前关于肝硬化患者的肠道准备方案的研究报道还很少。本综述的目的是总结影响特殊人群肠道清洁质量的危险因素的证据，以及改善这些患者结肠镜检查肠道准备的策略。

Abstract: This paper reviews the relevant studies on the factors affecting the quality of intestinal preparation before colonoscopy in the elderly, diabetes, chronic constipation, inflammatory bowel disease, cir-rhosis, chronic kidney disease and other special populations, and points out that the success rate of intestinal cleaning in the elderly can be improved through long-term low-fiber diet, graded dose regimen and colonoscopy within 5 hours after the completion of intestinal preparation. In addition, although there is no specifically recommended method of bowel preparation for other diffi-cult-to-perform patients, clinical evidence suggests that 1 L PEG plus ascorbate preparations are associated with higher intestinal cleansing success in patients with inflammatory bowel disease. Patients with severe renal insufficiency (creatinine clearance < 30 mL/min) should be treated with isotonic high-volume PEG solution for intestinal cleansing. At present, there are few studies on in-testinal preparation protocols in patients with cirrhosis. The aim of this review was to summarize the evidence on risk factors that affect the quality of bowel cleaning in particular populations, as well as strategies to improve bowel preparation for colonoscopy in these patients.