摘要
目的了解本区域结肠镜检查患者肠道清洁现状,探讨其影响因素,为临床指导患者肠道准备提供参考依据。方法采用系统抽样法前瞻性收集2018年4-9月安徽省六安市第二人民医院内镜中心行电子结肠镜检查421例患者的临床资料,包括患者一般资料、肠道准备相关资料及Boston肠道准备量表评分。采用回归分析模型对肠道准备的相关因素进行单因素分析和Logistic回归分析。结果421例患者中肠道清洁不合格者52例,不合格率为12.35%(52/421)。Logistic回归分析表明,结肠镜检查前肠道准备总饮水量(OR=1.674,P=0.018)、服药后总排便次数(OR=1.270,P=0.014)、末次排便性状(OR=2.211,P=0.042)、检查前1d饮食性状(OR=0.553,P=0.006)、体质量指数(OR=1.111,P=0.042)、肠道疾病(P=0.022)均为肠道清洁效果的独立影响因素;而服用甘露醇或复方聚乙二醇电解质散(PEG)、服药及饮水速度(3h内)、首次排便时间、服药地点、日常活动量等均不影响肠道准备效果(P>0.05)。结论结肠镜检查前肠道准备总饮水量<2000ml、服药后总排便次数≤5次、末次排便含残渣、检查前1d禁食严格、体质量指数<18.5kg/m^2、肠炎、溃疡和占位性病变均为影响肠道清洁效果的独立危险因素。注重肠道准备过程中的舒适护理和指导,进行前瞻性干预,能有效提高肠道清洁效果。
Objective To investigate the situation and influencing factors of bowel cleansing in patients before colonoscopy, and to provide reference for guiding patients′ bowel preparation. Methods The clinical data of 421 patients undergoing electronic colonoscopy in the endoscopy center of the second people′s hospital of Lu′an city in Anhui Province from April to September 2018, Prospective collection by systematic sampling, including general data of patients, clinical data of bowel preparation and score of Boston bowel preparation scale. Univariate analysis and logistic regression analysis were performed on the relevant factors of bowel preparation. Results Among the 421 patients, 52 cases were not eligible for intestinal cleaning, and the unqualified rate was 12.35%(52/421). Logistic regression analysis showed that: Total amount of drinking water prepared for intestinal tract before colonoscopy (OR=1.674, P=0.018),The total times of defecations after taking the drug (OR=1.270, P=0.014), the characteristics of last stool before colonoscopy (OR=2.211, P=0.042), the diet the day before colonoscopy (OR=0.553, P=0.006), body mass index (OR=1.111, P=0.042), and intestinal diseases (P=0.022), were all intestinal clearance independent influencing factors of cleaning effect;While took laxative type (mannitol/PEG), drunk water speed (within 3 hours), first defecation time, the site of drinking bowel-clearing drugs, daily activity, none of the above factors affected the bowel preparation effect (P>0.05). Conclusion Before colonoscopy, there were many factors affecting the cleaning effect of the intestine. The total water intake of intestinal preparation was less than 2 000 ml, the total number of defecation after taking medicine was less than 5 times, the last defecation contained residue, the day before the examination was strictly fasting, the body mass index was less than 18.5 kg/m^2, and colitis, enterelcosis and occupying lesion are independent risk factors for intestinal cleaning. Attention should be paid to the comfort care and guidance of intestinal preparation, and prospective intervention can effectively improve the cleaning effect of intestinal tract.
作者
徐绍莲
唐瑭
陈静
余有声
朱贞祥
陈本鑫
Xu Shaolian;Tang Tang;Chen Jing;Yu Yousheng;Zhu Zhenxiang;Chen Benxin(Department of Nursing,The Second People′s Hospital of Lu′an City,Anhui Province (The Affiliated Hospital of Western Anhui Health Vocational College),Lu′an 237008,China;Endoscopy Center,The Second People′s Hospital of Lu′an City,Anhui Province (The Affiliated Hospital of Western Anhui Health Vocational College),Lu′an 237008,China;General Surgery,The Second People′s Hospital of Lu′an City,Anhui Province (The Affiliated Hospital of Western Anhui Health Vocational College),Lu′an 237008,China;Department of Gastroenterology,The Second People′s Hospital of Lu′an City,Anhui Province (The Affiliated Hospital of Western Anhui Health Vocational College),Lu′an 237008,China)
出处
《中国实用护理杂志》
2019年第29期2256-2262,共7页
Chinese Journal of Practical Nursing
基金
安徽省高校自然科学研究项目(KJ2018A0960).
