摘要
目的探究肠道准备质量相关影响因素及其对肠道分段肠道准备质量评分是否存在影响差异。方法按入排标准纳入从2021年11月至2022年11月在深圳市某三甲医院394名行结肠镜检查的患者,前瞻性地收集患者和结肠镜相关检查数据,采用波士顿肠道准备量表(Boston Bowel Preparation Scale,BBPS)评估肠道准备质量的情况,用多因素Logistic回归分析得出与肠道准备不充分的独立因素,利用趋势卡方检验探究各危险因素对肠道分段肠道准备质量评分是否存在影响差异。结果肠道准备不充分比率20.8%,息肉或腺瘤检出率为20.3%,采用logistic回归分析结果显示肠道质量欠佳的独立危险因素为未服用西甲硅油(OR=2.236)、摄入聚乙二醇<75%(OR=3.337)、Bristol 1型及2型(OR=3.359)、末次大便有渣(OR=6.664)、检查时间间隔>6小时(OR=2.483)(P值均<0.05)。其中西甲硅油组横结肠、右半结肠肠道准备评分比无西甲硅油组要高(P<0.05),左半结肠肠道准备评分差异无统计学意义;摄入清肠剂剂量>75%组左半结肠肠道准备评分比摄入清肠剂剂量≤75%组高(P<0.05),右半结肠及横结肠肠道准备评分差异无统计学意义;Bristol评分3型至7型组左半结肠、横结肠肠道准备评分比Bristol 1型及2型组要高(P<0.05),右半结肠肠道准备评分差异无统计学意义;末次大便无渣组肠道准备评分左半结肠肠道准备评分比末次大便有渣组要高(P<0.05),右半结肠、横结肠肠道准备评分差异无统计学意义;检查间隔时间≤6 h组左半结肠、右半结肠、横结肠肠道准备评分比检查间隔时间>6 h要高(P<0.05)。结论该研究识别出了与肠道清洁质量欠佳的因素并且总结出其对各肠道的影响差异,通过为患者制定规范及个体化的肠道准备方案,对患者平素大便性状及排便情况进行记录,合理安排检查时间有利于进一步提升肠道清洁效果。
Objective To analyze the influencing factors of inadequate bowel preparation in patients undergoing colonoscopy and explore if the influence on different bowel segment is significant.Methods A total of 394 patients undergoing colonoscopy in a tertiary A hospital in Shenzhen from November 2021 to November 2022 were enrolled according to the inclusion and exclusion criteria.Patients′and colonoscopy′s relevant information were prospectively collected,bowel preparation quality was assessed by Boston Bowel Preparation Scale(BBPS).Then the Logistic regression analysis was used to analyze the independent risk factors,and 2 test was used to analyze if the influence on different bowel segment is significant.Results Inadequate bowel preparation was seen in 20.8%of cases,rates of polyp detection and adenoma(PDR and ADR)is 20.3%.Factors associated with inadequate bowel preparation according to Logistic regression analysis included not taking simethicone(OR=2.236),<75%consumption of PEG(OR=3.359),patients with Bristol stool types 1 and 2(OR=3.359),the last defecation consisting of solid composition(OR=6.664),the time interval between bowel preparation and colonoscopy>6 h(OR=2.483)(all P<0.05).The bowel preparation score of transverse colon and right colon in simethicone group was higher than the other group(P<0.05),while there was no difference in left colon.The bowel preparation score of left colon in>75%consumption of PEG group was higher than the other group,while there was no difference in transverse and right colon.The bowel preparation score of left colon and transverse colon in Bristol stool types 3 to 7 group was higher than Bristol stool types 1 and 2 group,while there was no difference in right colon.The bowel preparation score of left colon in the last defecation consisting of solid composition was higher than the other group,while there was no difference in right and transverse colon.The bowel preparation score of three colon segments in the time interval between bowel preparation and colonoscopy<6 h group was
作者
张淑娥
吴建维
吕志武
ZHANG Shu-e;WU Jian-wei;L Zhi-wu(The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510515,China;The People′s Hospital of Baoan Shenzhen,Shenzhen 518101,China)
出处
《现代消化及介入诊疗》
2023年第2期145-150,155,共7页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
深圳市科技计划项目(JCYJ2018005123709909)。
