대장내시경 전 처치제로서 Sulfate Free Polyethylene Glycol 용액과 Sodium Phosphate 용액의 전향적 비교 분석
A Prospective Comparison of Sulfate Free Polyethylene Glycol versus Sodium Phosphate Solution for Precolonoscopic Bowel Preparation
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목적: Polyethylene glycol (PEG) 용액은 안전하고 정결 효과가 우수하여 대장내시경 전 처치제로 널리 사용되고 있지만, 짠 맛과 많은 양으로 인해 환자의 순응도가 낮은 것이 제한 점이다. 이번 연구에서는 sodium sulfate을 제거해 맛을 개선한 sulfate free PEG (SF-PEG) 용액과 Sodium phosphate (NaP) 용액의 대장 전 처치제로서 대장 정결 효과와 환자 순응도를 비교 분석하고자 하였다. 대상 및 방법: 2007년 2월부터 2007년 4월까지 서울백병원에서 대장내시경을 시행 받은 총 534명의 환자들에 대해 무작위 전향적 대조 연구를 시행하였다. 시술자 설문지를 통해 대장 정결도를 조사하였고, 환자 설문지를 통해 순응도를 조사하였다. 결과: 대장 정결도에서 “잔류 변 및 액체” 평가는 두 군 사이에 유의한 차이가 없었으나(2.07 vs. 2.14, p=0.149), “공기방울” 평가(1.34 vs. 1.71, p＜0.001)와 전체적인 평가(0.72 vs. 0.91, p=0.010)에서는 SP-PEG군이 NaP군보다 유의하게 우수하였다. 환자의 순응도에서 “맛”은 두 군 사이에 유의한 차이가 없었으나(2.14 vs. 2.25, p=0.148), “양”은 NaP군을 의미 있게 선호하였다(2.46 vs. 1.81, p＜0.001). 결론: SF-PEG 용액은 대장 정결도가 우수하며 기존 PEG 용액의 문제점이었던 맛을 개선하였지만, 양이 많아 환자의 순응도가 낮은 것이 단점으로 남아있다.
Abstract
Background/Aims: Polyethylene glycol (PEG) solution is commonly used for precolonoscopic preparation because of its safety and effectiveness. Sulfate free PEG (SF-PEG) solution was developed to reduce the salty taste by removing the sodium sulfate. The aim of this study was to compare the efficacy and patient compliance of SF-PEG and sodium phosphate (NaP) solutions for preparing the bowel before colonoscopy. Methods: From February through April in 2007, 534 patients who underwent colonoscopy were prospectively enrolled. The efficacy of bowel cleansing was assessed by a doctor's questionnaire and the patient's compliance was assessed by a patient's questionnaire. Results: There was no significant difference between the groups for the "stools and fluids" assessment of bowel cleansing (2.07 vs. 2.14, respectively, p=0.149). However, SF-PEG was more effective on the "air bubbles" assessment (1.34 vs. 1.71, respectively, p＜0.001) and the overall assessment (0.72 vs. 0.91, respectively, p=0.010) than NaP. The patients preferred SF-PEG rather than NaP for "Taste" (1.34 vs. 2.25, respectively, p=0.148). However, the patients significantly preferred NaP rather than SF-PEG for "Quantity" (2.46 vs. 1.18, respectively, p＜0.001). Conclusions: The SF-PEG solution showed more effectiveness for bowel cleansing as compared to the NaP solution. SF-PEG tastes better than NaP, but patients are still required to consume 4 liters for the standard preparing regimen.
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