儿童结肠镜检查前实施基于Bristol粪便性状评估的个性化肠道准备的临床研究

A Clinical Study on the Personalized Intestinal Preparation Based on Bristol Evaluation of Stool Characters before Children Receiving Coloscopy

目的:探讨基于Bristol粪便性状评估的个性化肠道准备用于儿童结肠镜检查的临床效果。方法:选择2019年4月至2021年5月于我院拟行结肠镜检查的160例患儿为研究对象,患儿均应用聚乙二醇电解质散(舒泰清)进行肠道准备(1包A剂+1包B剂兑水125 mL,100 mL/kg);结肠镜检查前一天12∶00和17∶00各口服1/2剂量;检查日6∶00采用Bristol粪便性状评估法评估患儿大便性状,Bristol 1~5型者追加聚乙二醇电解质散20 mL/kg口服;检查日11∶00评估末次大便性状,Bristol 1~5型者取消当日肠镜检查,Bristol 6型者予温生理盐水(50 mL/kg)灌肠,Bristol 7型者不予温生理盐水灌肠。检查日13∶00进行结肠镜检查。统计总体肠道准备效果,分析灌肠者与未灌肠者肠道准备效果。结果:160例患儿肠道准备合格145例(90.63%),不合格15例;接受灌肠40例,未接受灌肠120例。灌肠组与未灌肠组患儿肠道准备总体质量、肠道准备合格率、进镜至回盲部用时、结肠镜检查用时比较差异均无统计学意义,P>0.05。结论:儿童结肠镜检查前肠道准备时,根据Bristol粪便性状评估调整肠道准备方案,可有效提高肠道准备效果。

Objective To investigate the efficacy of personalized intestinal preparation(PIP)based on Bristol evaluation of stool characters before children receiving coloscopy.Methods The 160 pediatric patients to be subject to coloscopy in author’s hospital(2019-04-2021-05)were enrolled into this study:using Shutaiqing for bowel preparation(1 bag of A agent+1 bag of B agent,added with 125 mL of water,100 mL/kg);on the day before coloscopy,at 12∶00 and 17∶00,orally administered 1/2 dosage;on the day of coloscopy 6∶00,Bristol evaluation of stool characters in Bristol 1-5 types,again added 20 ml/kg of Shutaiqing;on the day of coloscopy 11∶00,the evaluation of last-stool characters 1-5types,canceled coloscopy on the day;in 6 type,warm normal saline(50 mL/kg)for enema,but in 7 type,not;on the day of coloscopy 13∶00,taking coloscopy.Then,recorded whole preparation efficacy for analysing and comparing efficacy between who with enema and who without enema.Results Among 160 cases,145 accorded(90.63%),15 not accorded;who with enema were of 40,without,of 120(cases).In whole preparation quality,accordance rate of preparation,the time from entrance of coloscope to ileocecal site,and the time for coloscopy there was no statistical difference between who with enema and who without enema(P>0.05).Conclusion Before children receiving coloscopy according Distol evaluation of stool characters to regulate the schema for intestinal preparation,can effectively enhance its efficacy.