Preparación para colonoscopia en 2016: recomendaciones actuales utilizando datos nacionales

Daniel Ruiz-Romero, Félix Ignacio Téllez-Ávila
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引用次数: 1

Abstract

Colonoscopy is still the method of choice for the prevention and monitoring of colorectal cancer and premalignant lesions. Proper preparation is essential for attaining optimal visualisation and evaluation of the colon mucosa. Although the ideal method of preparing the colon must be safe, well tolerated, inexpensive, and effective, none of the options that we currently have meets all of these features. A low-residue diet is more tolerable and as effective as a diet with liquids only. Within the available solutions, polyethylene glycol (PEG) and the combination of sodium picosulfate + magnesium oxide + citric acid (PicoPrep) are the two most commonly used solutions, either alone or combined with other drugs to enhance the quality of the preparation and tolerability. Both are equally effective; however, polyethylene glycol is the only one that can be used in various clinical situations, such as pregnancy, the elderly, dehydration, cirrhosis, heart failure, and kidney failure. On the other hand, although the sodium phosphate solution is better tolerated, it is increasingly being used less because it can cause acute kidney injury and severe electrolyte abnormalities; thus it is no longer recommended for use in all patients. Although there is evidence for the efficacy of loperamide and simethicone as adjuvants to preparation, they are yet not recommended for routine use in the various schemes of bowel cleansing. This article describes the different options for preparation prior to colonoscopy, including diet, solutions, adjuvants, as well as how to properly assess the quality of the preparation.

2016年结肠镜检查的准备工作:使用国家数据的当前建议
结肠镜检查仍然是预防和监测结直肠癌和癌前病变的首选方法。正确的准备对于实现结肠粘膜的最佳可视化和评估至关重要。尽管制备结肠的理想方法必须是安全、耐受性好、廉价和有效的,但我们目前的选择都不能满足所有这些特点。低残留饮食比只吃液体的饮食更容易忍受,也更有效。在现有的溶液中,聚乙二醇(PEG)和皮硫酸钠+氧化镁+柠檬酸的组合(PicoPrep)是两种最常用的溶液,可以单独使用,也可以与其他药物联合使用,以提高制剂的质量和耐受性。两者都同样有效;然而,聚乙二醇是唯一一种可以用于各种临床情况的药物,如妊娠、老年、脱水、肝硬化、心力衰竭和肾衰竭。另一方面,尽管磷酸钠溶液的耐受性更好,但它的使用越来越少,因为它会导致急性肾损伤和严重的电解质异常;因此不再推荐在所有患者中使用。尽管有证据表明洛哌丁胺和西美酮作为制剂佐剂的疗效,但它们仍不建议在各种肠道清洁方案中常规使用。本文介绍了结肠镜检查前准备的不同选择,包括饮食、溶液、佐剂,以及如何正确评估准备的质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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