排便频次与肠道准备质量的相关性研究

Correlation between defecation frequency and quality of bowel preparation

摘要:

目的 探讨按照不同排便频次进行个体化肠道准备对肠道准备质量的影响。方法 选取2020年1月－2020年3月符合纳入标准的240例门诊结肠镜检查患者。按排便频次分为A、B、C组，每组各80例。A组：排便频次1～3 d一次，肠道准备方案为2 L水加2盒复方聚乙二醇电解质散（PEG）方案；B组：排便频次 >3 d一次，肠道准备方案为2 L水加2盒PEG；C组：排便频次 >3 d一次，肠道准备方案为检查前1天1 L水加1盒PEG，检查当天2 L水加2盒PEG。均由同一组内镜医生和护士采用波士顿肠道准备评分（BBPS）和腺瘤检出率（ADR）来评价肠道准备质量，用问卷调查的方法评估患者肠道准备期间的不良反应发生情况。结果 A、B、C组肠道准备清洁度评分分别为（7.35±1.08）、（6.50±1.73）和（7.44±0.95）分，3组间比较，差异有统计学意义（F = 12.77，P = 0.000）；B组与A组比较，差异有统计学意义（t = 3.76，P = 0.000）；C组与B组比较，差异有统计学意义（t = -4.26，P = 0.000）；C组与A组比较，差异无统计学意义（t = -0.54，P = 0.590）。3组ADR分别为43.8%、28.8%和46.3%，组间比较，差异有统计学意义（χ² = 5.99，P = 0.049）；B组与A组比较，差异有统计学意义（χ² = 3.90，P = 0.048）；C组与B组比较，差异有统计学意义（χ² = 5.23，P = 0.022）；C组与A组比较，差异无统计学意义（χ² = 0.10，P = 0.751）。3组患者恶心、呕吐、腹痛和腹胀等常见不良反应发生率比较，差异无统计学意义（P >0.05）。结论 对于排便频次低的患者在检查前1天加服1盒PEG，可提高肠道准备质量，减少漏诊率，且不会增加不良反应发生率。

Abstract:

Objective To explore individualized bowel preparation according to different defecation frequency in order to improve the quality of bowel preparation.Methods 240 patients who met the inclusion criteria were enrolled and received colonoscopy in outpatient department from January 2020 to March 2020. The patients were classified into 3 groups according to their defecation frequency, with 80 patients in each group. Group A: the defecation frequency was once every 1 to 3 days, intestinal preparation regimen was 2 L water plus 2 boxes of polyethylene glycol electrolytes powder (PEG); Group B: defecation frequency >3 d once, intestinal preparation regimen was 2 L water plus 2 boxes of compound polyethylene glycol electrolyte powder (PEG); Group C: defecation frequency > 3 d once, intestinal preparation regimen was 1 L water and 1 box of PEG 1 day before examination, and 2 L water and 2 boxes of PEG 2 days before examination. The fixed endoscopist and nurse evaluated the quality of bowel preparation according to Boston bowel preparation score (BBPS) and adenoma detection rate (ADR). The adverse reactions were recorded by questionnaires.Results The scores of bowel cleanliness in Group A, B and C were respectively (7.35 ± 1.08), (6.50 ± 1.73) and (7.44 ± 0.95). There were statistically significant differences among 3 groups (F = 12.77, P = 0.000). There was statistically significant difference between Group B and A (t = 3.76, P = 0.000), as well as Group C and B (t = -4.26, P = 0.000), but no significant difference between C and A (t = -0.54, P = 0.590). The ADR of Group A, B and C were 43.8%, 28.8% and 46.3%, respectively, there was statistically significant differences among three groups (χ² = 5.99, P = 0.049); With statistically significant difference between Group A and B (χ² = 3.90, P = 0.048), as well as B and C (χ² = 5.23, P = 0.022), while with no statistically significant between Group A and C (χ² = 0.10, P = 0.751). There were no statistically significant differences in the common adverse reactions of the three groups, like nausea, vomiting, abdominal pain and bloating (P > 0.05).Conclusion For those patients with the lower frequency of defecation compared to normal, a box of PEG can be added the day before examination in order to improve the quality of intestinal preparation, as well as reducing the rate of missed diagnosis and without any possibility of increased occurrence of adverse reactions.