随机临床试验：结肠镜检查前一天的正常热量低纤维饮食是结肠直肠癌筛查结肠镜检查中肠道准备的最有效方法。,Diseases of the Colon & Rectum

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随机临床试验：结肠镜检查前一天的正常热量低纤维饮食是结肠直肠癌筛查结肠镜检查中肠道准备的最有效方法。
Diseases of the Colon & Rectum ( IF 3.2 ) Pub Date : 2019-03-08 , DOI: 10.1097/dcr.0000000000001305
Marco A Alvarez-Gonzalez _{1,

2} , Miguel A Pantaleon _{1,

2} , Juana A Flores-Le Roux _{2,

3} , Diana Zaffalon ₁ , Jaume Amorós ₄ , Xavier Bessa _{1,

2} , Agustin Seoane ₁ , Juan Pedro-Botet _{2,

3} ,

Affiliation

背景技术临床指南推荐用于结肠镜检查准备的清液饮食或低纤维饮食。筛查计划的参与者通常是积极进取的健康个体，其中良好的耐受性对于提高对潜在监测结肠镜检查的依从性很重要。目的我们的目的是评估结肠镜检查筛查前一天是否摄入了正常热量的低纤维饮食是否会损害肠道清洁的功效，并可能改善肠道准备的耐受性。设计这是一项随机，内镜盲的非劣效性临床试验。设置该研究在三级护理中心进行。患者共有276位巴塞罗那大肠癌筛查计划连续参与者参加。干预在结肠镜检查的前一天，将参与者随机分配为清水饮食或低热量的低热量饮食。两组均以分剂量方案接受4 L聚乙二醇。主要观察指标主要结果是用波士顿肠道准备量表测量的足够的肠道准备率。次要结果包括耐受性，体液摄入感知，饥饿，副作用和可接受性。结果两组受试者的基线特征相似。清肠饮食和低纤维饮食组的肠道准备充足率分别为89.1％和95.7％，这不仅显示出劣势，而且表现出优越性（p = 0.04）。低纤维饮食参与者的液体摄入量较少（p = 0.04），饥饿感较少（p = 0.006），腹胀或恶心无差异。局限性研究的单中心设计可能会限制结果的外部有效性。目前的发现可能无法与其他临床设置相提并论。结论在结肠镜检查充分的前提下，结肠镜筛查前一天的正常热量低纤维饮食比透明液体饮食获得更好的结果。此外，它还改善了饥饿感和过多饮水的感觉。在Clinicaltrials.gov上注册：NCT02401802。请参阅http://links.lww.com/DCR/A829上的视频摘要。此外，它还改善了饥饿感和过多饮水的感觉。在Clinicaltrials.gov上注册：NCT02401802。请参阅http://links.lww.com/DCR/A829上的视频摘要。此外，它还改善了饥饿感和过多饮水的感觉。在Clinicaltrials.gov上注册：NCT02401802。请参阅http://links.lww.com/DCR/A829上的视频摘要。

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Randomized Clinical Trial: A Normocaloric Low-Fiber Diet the Day Before Colonoscopy Is the Most Effective Approach to Bowel Preparation in Colorectal Cancer Screening Colonoscopy.

BACKGROUND Clinical guidelines recommend either a clear-liquid diet or a low-fiber diet for colonoscopy preparation. Participants in a screening program are usually motivated healthy individuals in which a good tolerability is important to improve adherence to potential surveillance colonoscopies. OBJECTIVE Our aim was to assess whether or not a normocaloric low-fiber diet followed the day before a screening colonoscopy compromises the efficacy of bowel cleansing and may improve the tolerability of bowel preparation. DESIGN This is a randomized, endoscopist-blinded, noninferiority clinical trial. SETTINGS The study was conducted at a tertiary care center. PATIENTS A total of 276 consecutive participants of the Barcelona colorectal cancer screening program were included. INTERVENTION Participants were randomly assigned to a clear-liquid diet or a normocaloric low-fiber diet the day before the colonoscopy. Both groups received 4 L of polyethylene glycol in a split-dose regimen. MAIN OUTCOME MEASURES Primary outcome was the adequate bowel preparation rate measured with the Boston bowel preparation scale. Secondary outcomes included tolerability, fluid-intake perception, hunger, side effects, and acceptability. RESULTS Participants in both groups were similar in baseline characteristics. Adequate bowel preparation was achieved in 89.1% vs 95.7% in clear-liquid diet and low-fiber diet groups, showing not only noninferiority, but also superiority (p = 0.04). Low-fiber diet participants reported less fluid-intake perception (p = 0.04) and less hunger (p = 0.006), with no differences in bloating or nausea. LIMITATIONS The single-center design of the study could limit the external validity of the results. The present findings may not be comparable to other clinical settings. CONCLUSION A normocaloric low-fiber diet the day before a screening colonoscopy achieved better results than a clear-liquid diet in terms of adequate colon preparation. Moreover, it also improved the perception of hunger and excessive fluid intake. Registered at clinicaltrials.gov: NCT02401802. See Video Abstract at http://links.lww.com/DCR/A829.

更新日期：2019-11-01

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