结肠镜检查中盲肠插管率的预测因素分析

Analysis of the predictive factors of the rate of blind intubation failed cecal intubation in colonoscopy

摘要:

目的 研究结肠镜检查中影响盲肠插管率的预测因素。方法 回顾性分析该院2019年1月－2020年1月收治的87例接受结肠镜检查的患者临床资料。分析盲肠插管率，统计患者年龄、性别、体重指数（BMI）、肠镜史、肠道准备质量、焦虑自评量表（SAS）评分、清肠药物、排便习惯、慢性疾病、手术史、疼痛视觉模拟评分（VAS）等一般资料，采用多因素Logistic回归分析法分析影响结肠镜检查中盲肠插管率的独立危险因素。结果 87例接受结肠镜检查的患者中，有14例（16.09%）盲肠插管失败，纳为失败组；其余73例（83.91%）进镜成功，纳为成功组。两组患者性别、肠镜史、清肠药物、慢性疾病、手术史比较，差异均无统计学意义（P > 0.05）；失败组高龄、肠道准备质量较差、便秘、低BMI占比明显高于成功组，SAS评分、VAS评分明显高于成功组（P < 0.05）。多因素Logistic回归分析显示，高龄（O = 3.122，95%CI：1.036～9.215）、肠道准备质量较差（O = 4.362，95%CI：1.789～10.968）、便秘（O = 3.165，95%CI：1.086～9.365）、低BMI（O = 2.795，95%CI：1.236～4.548）、高SAS评分（O = 1.965，95%CI：1.197～8.635）、高VAS评分（O = 3.426，95%CI：1.196～6.985）是影响结肠镜检查中盲肠插管率的独立危险因素（P < 0.05）。结论 高龄、便秘、肠道准备质量较差、高SAS评分、低BMI、高VAS评分与结肠镜检查中盲肠插管率密切相关，有一定预测价值。

Abstract:

Objective To study the predictors of cecal intubation rate in colonoscopy.Methods A retrospective analysis of the clinical data of 87 patients underwent colonoscopy from January 2019 to January 2020. Analyze the rate of cecal intubation, and count the patient’s age, gender, body mass (BMI) index, colonoscopy history, bowel preparation quality, anxiety (SAS) score, bowel cleansing drugs, bowel habits, chronic diseases, and surgical history, Pain Visual Analog Scale (VAS) and other general data, Multivariate Logistic regression analysis was used to analyze independent risk factors that affect the rate of cecal intubation during colonoscopy.Results Among 87 patients underwent colonoscopy, 14 (16.09%) failed blind endoscopic intubation and were included in the failure group; the remaining 73 cases (83.91%) were successful in the endoscopy and were included in the successful group. There was no significant difference in the proportions of gender, colonoscopy history, bowel cleansing drugs, chronic diseases, and surgical history between the two groups (P > 0.05); the proportion of the failure group was older, poorer bowel preparation, constipation, and low BMI and SAS score and VAS score were significantly higher than the success group (P < 0.05). Multivariate Logistic regression analysis showed that advanced age (O = 3.122, 95%CI: 1.036～9.215), poor quality of bowel preparation (O = 4.362, 95%CI: 1.789～10.968), constipation (O = 3.165, 95%CI: 1.086～9.365), low BMI (O = 2.795, 95%CI: 1.236～4.548), high SAS score (O = 1.965, 95%CI: 1.197～8.635), high VAS score (O = 3.426, 95%CI: 1.196～6.985) was an independent risk factor affecting the rate of cecal intubation during colonoscopy (P < 0.05).Conclusion Old age, constipation, poor quality of bowel preparation, high SAS score, low BMI, and high VAS score are closely related to the rate of cecal intubation during colonoscopy, and have certain predictive value.