肠道准备关键点指导方案在老年患者结肠镜检查中的应用研究*

Application of the key-point guidelines of bowel preparation for elderly patients with colonoscopy*

摘要:

旨在探讨肠道准备关键点指导方案在老年结肠镜检查患者中的应用效果，从而为临床开展科学规范的肠道准备指导工作提供参考依据。方法 选取2017年2月－2017年9月行结肠镜检查的老年门诊患者206例，对照组和干预组各103例。其中对照组在预约时给予常规的肠道准备指导，干预组在常规肠道准备指导的基础上给予基于肠道准备关键点指导方案的干预措施，评价并比较两组患者的肠道清洁效果、肠道准备依从性和肠道准备期间不良反应发生率等结局指标。结果 干预组患者的肠道准备合格率及渥太华肠道清洁度评分（OBPS）均优于对照组（P <0.01）；干预组患者的进镜时间短于对照组（P <0.01）；干预组不依从饮食、服药及运动的患者比例均低于对照组（P <0.01）；干预组患者服药期间发生恶心、腹胀的情况远低于对照组（P <0.01）。此外，干预组对肠道准备的总体满意程度及愿意再次行肠镜检查的患者比例也明显优于对照组（P <0.01）。结论 在肠道准备期间，根据肠道准备关键点指导方案对老年患者进行指导，不仅有利于医护人员更加科学规范地进行肠道准备指导工作，并且方案内容高度契合老年结肠镜检查患者的实际需求，便于实施推广，具有较好的临床实用价值。

Abstract:

Abstract: Objective?To evaluate the key-point guidelines of bowel preparation for elderly patients with colonoscopy, in order to provide reference for the implementation of scientific and standardized bowel preparation guidance. Methods In this study, 206 elderly patients with colonoscopy were selected from February 2017 to September 2017, and 103 cases in control group and the intervention group respectively. The control group was given routine bowel preparation guidance at the time of appointment. Based on the routine bowel preparation guidance, the intervention group was given the key-point guidelines of bowel preparation, in order to explore the impact of the scheme on patients’ intestinal cleanliness, bowel preparation compliance, incidence of adverse reactions during bowel preparation and other outcome indicators in elderly patients underwent colonoscopy. Results The results showed that the rate of adequate bowel preparation and OBPS total score of the patients in the intervention group were better than those in the control group (P < 0.01). The insertion time of the patients in the intervention group was shorter than those in the control group (P < 0.01). The proportion of the patients who were non-compliance with dietary instructions, non-compliance with polyethylene glycol (PEG) dosage and non-compliance with exercise time in the intervention group was lower than those in the control group (P < 0.01). In addition, the proportion of patients with nausea and abdominal distention in the intervention group was much lower than those in the control group (P < 0.01). The overall satisfaction of bowel preparation and the willingness to repeat colonoscopy in the intervention group were significantly better than those in the control group (P < 0.01). Conclusion The intervention scheme provide a reference for the clinical implementation of standardized bowel preparation guidance and the content of the scheme is highly consistent with the actual needs of the elderly patients with colonoscopy, which is convenient for the implementation and has good clinical practical value.