直肠癌Miles术后患者结肠镜检查肠道准备方法的探讨

Discussion of colonoscopy preparation for colonoscopy in patients with rectal cancer after Miles surgery

摘要:

探讨直肠癌Miles术后患者结肠镜检查前的肠道准备方法。方法 纳入拟行结肠镜检查的90例直肠癌Miles术后患者，并随机分为A、B、C 3组，每组30例，A组于结肠镜检前6 h口服复方聚乙二醇电解质散（SF-PEG）328.8 g（3 000 ml）清洁肠道；B组结肠镜检查前6 h口服328.8 g SF-PEG，检查前2 h开塞露40 ml入结肠造口；C组检查前1 d三餐后2 h口服SF-PEG 27.4 g（250 ml），检查前6 h口服164.4 g（1 500 ml）SF-PEG，检查前2 h开塞露40 ml入结肠造口。3组患者检查前1 d进流食，当日禁食至检查完毕。内镜医师行Boston肠道准备量表（BBPS）和肠腔内气泡评分，采用问卷调查的方式评价患者对肠道准备的耐受性，记录肠道准备过程中的不良反应及肠镜检查时间。结果 C组BBPS总分（7.90±0.65）分明显高于A组（6.05±0.80）分和B组（6.65±0.35）分（P <0.05），C组肠腔内气泡评分（0.35±0.15）分明显 低于A组（0.75±0.35）分和B组（0.55±0.45）分（P <0.05），C组肠镜检查时间（9.25±0.80）min少于 A组（12.65±0.55） min和B组（10.50±0.75）min（P <0.05），C组肠道准备接受率（96.67%）高于A组 （80.00%）和B组（83.33%）（P <0.05），C组再次肠道准备接受率（90.00%）高于A组（60.00%）和B组 （70.00%）（P <0.05），C组总体不良反应评分（1.25±0.10）分明显低于A组（1.85±0.45）分和B组（1.55± 0.35）分（P <0.05）。结论 SF-PEG联合开塞露用于直肠癌Miles术后患者肠道准备能明显提高肠道准备质量，减少不良反应，增加其依从性和耐受性。

Abstract:

To investigate the method of bowel preparation before colonoscopy in patients with rectal cancer after Miles surgery.?Methods?90 patients with rectal cancer after Miles surgery underwent colonoscopy were enrolled and randomly divided into group A, B, and C, 30 patients in each group. Group A was orally administered with polyethylene glycol electrolyte (3 000 ml) 6 hours before colonoscopy cleaning the intestine. Group B was given 328.8 g SF-PEG 6 h before colonoscopy, 40 ml kaiselu used before the colostomy. Group C was taken orally 2 hours after meals, SF-PEG 164.4 g (1 500 ml) was taken orally 6 h before the examination, 40 ml of the kaiselu was injected into the colostomy 2 hours before the examination. The three groups of patients entered the food one day before the examination, and fasted until the examination was completed. Endoscopic physicians performed the Boston bowel preparation scale (BBPS) and intraluminal air bubble scores. The patient’s tolerance to bowel preparation was investigated by questionnaire, and adverse reactions and colonoscopy time during bowel preparation were recorded.?Results?The total score of BBPS in group C (7.90 ± 0.65) was significantly higher than that in group A (6.05 ± 0.80) and group B (6.65±0.35) (P ﹤ 0.05). The score of intestinal cavity in group C was (0.35 ± 0.15) was significantly lower than group A (0.75 ± 0.35) and group B (0.55 ± 0.45) (P ﹤ 0.05). Group C colonoscopy time (9.25 ± 0.80) was lower than group A (12.65 ± 0.55) and group B (10.50 ± 0.75) (P ﹤ 0.05), the intestinal preparation acceptance rate in group C (96.67%) was higher than that in group A (80.00%) and group B (83.33%) (P ﹤ 0.05). The preoperative acceptance rate (90.00%) was higher than that of group A (60.00%) and group B (70.00%) (P ﹤ 0.05). The overall adverse reaction score of group C (1.25 ± 0.10) was significantly lower than that of group A (1.85 ± 0.45) and group B (1.55 ± 0.35) (P ﹤ 0.05).?Conclusions?Compound polyethylene glycol electrolyte combined with kaiselu for intestinal preparation in patients with rectal cancer Miles can significantly improve the quality of bowel preparation, reduce adverse reactions, increase compliance and tolerance.