目的 探讨个体化肠道准备方案在老年患者肠镜检查中的应用。方法 选取2021-03至2022-03在解放军总医院第二医学中心消化内镜中心丙泊酚镇静麻醉下、接受无痛肠镜检查的老年患者98例,随机分为对照组与观察组,每组49例。对照组采用常规肠道准备,观察组采用个体化的肠道准备方案下的肠镜检查前肠道准备。对比两组肠道准备清洁度及患者对此肠道准备方案的满意度。结果 观察组波士顿肠道准备量表得分为(7.83±0.35)分,高于对照组的(6.91±0.73)分,差异有统计学意义(P＜0.05);两组患者满意度比较,观察组满意率98.00%高于对照组的79.60%,差异有统计学意义(P＜0.05)。结论 应用个体化肠道准备方案,波士顿评分高,清洁度好,患者满意度更高,值得推广。
Abstract
Objective To investigate the cleanliness of intestinal preparation and patient satisfaction during colonoscopy in elderly patients with personalized intestinal preparation.Methods A total of 98 elderly patients receiving painless colonoscopy under propofol sedation and anesthesia in the Digestive Endoscopy Center of the Second Medical Center of Chinese PLA General Hospital from March 2021 to March 2022 were randomly divided into control group and observation group, with 49 cases in each group. The control group received routine bowel preparation, and the observation group received individualized bowel preparation before colonoscopy. The cleanliness of intestinal preparation and patients’ satisfaction with the intestinal preparation were compared between the two groups.Results Individualized intestinal preparation program was implemented before colonoscopy in the elderly under intravenous anesthesia. The score of Boston Intestinal preparation Scale was (7.83±0.35) in the observation group and 6.91±0.73 in the control group. There was statistical difference in the overall mean score of Boston Intestinal preparation Scale between the two groups (P<0.05). The comparison of intestinal preparation satisfaction between the two groups showed that the satisfaction rate of the observation group was higher than that of the control group (98.00% vs 79.60%), and there was statistically significant difference(P<0.05).Conclusions The implementation of individualized intestinal preparation program greatly improves the satisfaction of patients with intestinal preparation, and the Boston score is significantly higher than that of the control group, and this program can improve the accessibility, continuity and standardization of care.
关键词
个体化方案 /
肠道准备 /
老年患者 /
静脉麻醉下肠镜
Key words
individualized program /
intestinal preparation /
elderly patients /
colonoscopy under intravenous anesthesia
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 房静远.中国大肠肿瘤筛查、早诊早治和综合预防共识意见[J].胃肠病学和肝病学杂志,2011,20(11):979-995.
[2] 王景华,王 璇,王小鹏,等.无痛胃肠镜检查中应用依托咪酯-丙泊酚混合液的麻醉效果[J].武警医学,2020,31(8):688-691,694.
[3] Ladabaum U, Dominitz J A, Kahi C,et al. Strategies for colorectal cancer screening[J]. Gastroenterology,2020,158(2): 418-432.
[4] 陈佩松,马镇坚,张洪实,等.老年患者结肠镜检查肠道准备不良的影响因素分析[J].现代消化及介入诊疗,2017,22(3):358-360.
[5] Kim H G, Jeon S R, Kim M Y, et al. How to predict adequate bowel preparation before colonoscopy using conventional polyethylene glycol: prospective observational study based on survey[J].Dig Endosc,2015,27(1): 87-94.
[6] 姜元喜,陈 莹,李 信,等.结直肠癌筛查高危患者结肠镜下息肉与腺瘤检出率的影响因素[J].中华消化内镜杂志,2015,32(10):649-652.
[7] Tian X, Shi B, Liu X L, et al. A Randomized trial of split dose 3 l polyethylene glycol lavage solution, 2 l polyethylene glycol lavage combined with castor oil, and 1 l of polyethylene glycol lavage solution combined with castor oil and ascorbic acid for preparation for colonoscopy[J].Front Med (Lausanne),2019,6: 158.
[8] Fang J, Wang S, Yu B, et al. Impact of gum chewing on the quality of bowel preparation for colonoscopy: an endoscopist-blinded, randomized controlled trial[J].Gastrointest Endosc, 2017, 86(1):187-191.
[9] ASGE Standards of Practice Committee, Buxbaum J L, Abbas Fehmi S M, et al. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis[J].Gastrointest Endosc,2019,89(6): 1075-1105.e15.
[10] Rutherford C C, Calderwood A H. Update on bowel preparation for colonoscopy[J].Curr Treat Options Gastroenterol,2018,16(1): 165-181.
[11] 李晓亮,文 姝,谢立群.复方聚乙二醇电解质散联合饮食干预在结肠镜检查肠道准备中的应用进展[J].武警医学,2020,31(2):163-167.
[12] Stolpman D R, Solem C A, Eastlick D, et al. A randomized controlled trial comparing a low-residue diet versus clear liquids for colonoscopy preparation: impact on tolerance, procedure time, and adenoma detection rate[J].J Clin Gastroenterol, 2014, 48(10):851-855.
[13] 胡洋洋, 凤 辉, 王少峰. 复方聚乙二醇与甘露醇法行结肠镜检前肠道准备的有效性及安全性Meta分析[J].世界华人消化杂志, 2015, 23(21):3469-3475.
[14] 张 智,葛兆霞,邓小岚.老年患者结肠镜检查前不同肠道准备方法的效果对比[J].中华现代护理杂志,2017,23(14):1829-1832.
[15] 刘 晓,史济华,赵 莉,等.普芦卡必利联合复方聚乙二醇电解质散对124例老年患者结肠镜肠道准备的效果观察[J].中华消化杂志,2016,36(8):559-562.
[16] Hong S C, Chan S S, Gyu W K, et al. Orange juice intake reduces patient discomfort and is effective for bowel cleansing with polyethylene glycol during bowel preparation[J].Dis Colon Rec, 2014, 10 (57):1220-1227.
PDF(984 KB)
