改良术前指导在老年患者结肠镜检查前肠道准备中的应用

Application of the improved preoperative guidance on bowel preparation in elderly patients undergoing colonoscopy

目的：探讨改良术前指导在老年人结肠镜检查中的有效性和安全性。方法将120例结肠镜检查前需进行肠道准备的住院老年患者随机分为观察组和对照组各60例，两组患者均在检查前3 d进无渣饮食，检查前1d晚餐进流质饮食，检查当天空腹，服用导泻药物磷酸钠盐口服溶液。观察组以改良术前指导宣教，对照组以传统术前指导宣教，观察患者肠道准备质量、恶心呕吐等不良反应发生情况、血压心率呼吸波动范围情况。结果观察组患者肠道准备质量满意53例，明显高于对照组的40例，差异有统计学意义（χ2＝8．0765，P＜0．01）；恶心、呕吐等不良反应发生率显著低于对照组，差异有统计学意义（χ2值分别为11．1166，13．3308，10．1086，7．5294；P＜0．01）；检查前两组患者血压、心率、呼吸测量结果比较差异无统计学意义（P＞0．05）；检查后观察组患者血压、心率、呼吸测量结果低于对照组，差异均有统计学意义（ P＜0．01）。结论在老年患者结肠镜检查术前准备中改良术前指导更安全、更有效，具有重要临床指导意义。

Objective To explore the effectiveness and safety of the improved preoperative guidance on bowel preparation in elderly patients undergoing colonoscopy .Methods One hundred and twenty elderly patients undergoing colonoscopy were randomly divided into the observation group and the control group , each with 60 cases.The patients all received the non-residue diet three days before examination , liquid diet at the dinner one day before examination , fasting at the day of examination , and the sodium phosphate oral solution as the purgation medicine .The observation group received the improved preoperative guidance , and the control group received the conventional preoperative guidance .The quality of bowel preparation , the incidence rates of adverse reactions including nausea and vomiting , and the variabilities in blood pressure , heart rate and respiration were observed .Results The cases of patients who were pleased with the quality of bowel preparation were 53 cases in the observation group , and were significantly higher than 40 cases in the control group , and the difference was statistically significant （χ2 =8.0765, P ＆lt;0.01 ）.The incidence rates of adverse reactions including nausea and vomiting in the observation group were significantly lower than those in the control group , and the differences were statistically significant （χ2 =11.116 6, 13.330 8, 10.108 6, 7.529 4, respectively;P〈0.01）.No differences were found in the blood pressure , heart rate and respiration before the examination in two groups （P〉0.05）;The blood pressure, heart rate and respiration in the observation group were lower than those in the control group after the examination, and the difference was statistically significant （P〈0.01）. Conclusions The improved preoperative guidance is more effectiveness and safety in bowel preparation in elderly patients with colonoscopy , and has important clinical significance .