比较高风险人群单用乳果糖与复方聚乙二醇进行肠道准备的效果与安全性。

选取2023年7月至2025年6月在天津医科大学第二医院消化科拟行结肠镜检查的高风险人群，采用随机数字表法分为乳果糖组（160例）和复方聚乙二醇组（160例），观察指标包括两组患者的肠道准备充分率、波士顿评分、结肠镜镜头清晰度评分、进镜及退镜时间、息肉及腺瘤检出率、首次排便间隔时间、血电解质、血糖、血压、血肌酐、血浆渗透压水平及不良反应，同时通过问卷调查患者愿意再次使用清肠方案的比例。计量资料的比较采用t检验，计数资料的比较采用χ²检验。

乳果糖组147例、复方聚乙二醇组145例完成研究。乳果糖组肠道准备充分率、波士顿评分、结肠镜镜头清晰度评分分别为72.8%（107/147）、（6.67±1.24）分、（1.28±0.33）分，复方聚乙二醇组分别为57.2%（83/145）、（6.31±1.20）分、（1.41±0.37）分，差异均有统计学意义（χ²=2.772，t=2.523、2.521；P<0.05或0.01）。乳果糖组息肉和腺瘤检出率分别为51.7%（76/147）、40.1%（59/147），复方聚乙二醇组分别为39.3%（57/145）、28.3%（41/145），差异均有统计学意义（χ²=2.119、2.126，P<0.05）。乳果糖组首次排便间隔时间为（1.16±0.44）h，复方聚乙二醇组为（1.44±0.97）h，差异有统计学意义（t=3.167，P<0.01）。乳果糖组清肠后不良反应总发生率和愿意再次使用的比例分别为21.1%（31/147）、95.2%（140/147），复方聚乙二醇组分别为46.9%（68/145）、82.8%（120/145），差异均有统计学意义（χ²=4.564、11.958，P<0.01）。

对于高风险人群，单用乳果糖进行肠道准备较复方聚乙二醇具有更好的清洁效果和更高的腺瘤检出率，不良反应发生率更低，且对血液循环影响小。

To compare the efficacy and safety of bowel preparation using lactulose alone versus compound polyethylene glycol electrolyte powder in high-risk populations.

High-risk individuals who were scheduled to undergo colonoscopy in the Gastroenterology Department of the Second Hospital of Tianjin Medical University from July 2023 to June 2025 were selected and divided into a lactulose group (160 cases) and a compound polyethylene glycol group (160 cases) using a random number table method. The observation indicators included the adequacy rate of bowel preparation, Boston score, colonoscope lens clarity score, time of advancing and withdrawing the scope, detection rate of polyps and adenomas, interval time to the first defecation, blood electrolyte levels, blood glucose levels, blood pressure, blood creatinine levels, plasma osmolarity levels, and adverse reactions in both groups of patients. Additionally, a questionnaire was used to investigate the proportion of patients who were willing to use the bowel cleansing regimen again. T test was used to compared the measurement data, Chi-square test was used to compared the count data.

147 patients in the lactulose group and 145 patients in the compound polyethylene glycol group completed the study. The adequacy rate of bowel preparation, Boston score, and colonoscopy lens clarity score in the lactulose group were 72.8% (107/147), (6.67±1.24) points, and (1.28±0.33) points, respectively, while those in the polyethylene glycol compound group were 57.2% (83/145), (6.31±1.20) points, and (1.41±0.37) points, respectively. The differences were statistically significant (χ²=2.772, t=2.523, 2.521; P < 0.05 or P < 0.01). The detection rates of polyps and adenomas in the lactulose group were 51.7% (76/147) and 40.1% (59/147), respectively, while those in the compound polyethylene glycol group were 39.3% (57/145) and 28.3% (41/145), respectively. The differences were statistically significant (χ²=2.119, 2.126; P < 0.05). The mean time to the first defecation in the lactulose group was (1.16±0.44) hours, while that in the compound polyethylene glycol group was (1.44±0.97) hours, with a statistically significant difference (t=3.167, P < 0.01). The total incidence of adverse reactions after bowel cleansing and the proportion of patients willing to use the medication again in the lactulose group were 21.1% (31/147) and 95.2% (140/147), respectively, while those in the compound polyethylene glycol group were 46.9% (68/145) and 82.8% (120/145), respectively. The differences were statistically significant (χ²=4.564, 11.958; P < 0.01).

For high-risk populations, using lactulose alone for bowel preparation exhibits better cleansing efficacy and a higher adenoma detection rate compared to compound polyethylene glycol, along with a lower incidence of adverse reactions and minimal impact on blood circulation.