老年人行走功能状态与结肠镜检查肠道准备质量的相关性分析

Correlation analysis between the walking function status and the quality of bowel preparation for colonoscopy in the elderly patients

目的 探讨老年人行走功能状态与结肠镜检查肠道准备质量的相关性。方法 回顾性分析200例行结肠镜检查的老年患者（≥ 70岁）的临床资料，通过日常生活能力评估量表（Schonberg指数）评定行走功能状态，其中行走功能正常114例（行走正常组），行走功能困难86例（行走困难组）。两组患者采取相同的肠道准备方案和教育指导方式，观察两组患者遵嘱执行肠道准备方案的依从性，调查未严格遵嘱的原因，采用波士顿肠道准备量表（BBPS）评估肠道清洁质量，采用Spearman秩相关检验进行等级资料行走功能状态与肠道准备依从性和肠道清洁质量的相关性分析。结果 行走困难组未完整服用清洁剂比例明显高于行走正常组[53.5%（46/86）比26.3%（30/114）]，差异有统计学意义（χ2= 15.362，P 〈 0.01）。行走困难组未能完整服用肠道清洁剂的原因依次为频繁上厕所行走不便39例，遗忘4例，不良反应3例。行走困难组整体肠道准备依从性好比例和肠道准备充分率明显低于行走正常组[41.9%（36/86）比65.8%（75/114）和55.8%（48/86）比72.8%（83/114）]，差异有统计学意义（χ2= 11.365和6.264，P〈0.01或〈0.05）。两组其他遵嘱执行肠道准备方案严格执行比例比较差异无统计学意义（P〉0.05）。相关性分析结果显示，老年人行走功能状态与肠道准备依从性和肠道清洁质量呈正相关（r= 0.238和0.177，P〈0.05）。结论 行走功能状态与老年结肠镜检查患者的肠道准备质量相关，行走困难可能预示老年患者肠道准备依从性和清洁程度欠佳。

Objective To investigate the correlation between the walking function status and the quality of bowel preparation for colonoscopy in the elderly patients.Methods Two hundreds elderly （over 70 years） patients undergoing colonoscopy were selected. The walking function status was evaluated by the ability of daily living scale （Schonberg index）, and the patients were divided into normal walking group （114 cases） and difficulty walking group （86 cases）. Patients in the 2 groups accepted the unified intestinal preparation programs and education guidance. The patients′ compliances to preparation instructions were observed. The causes of non-compliance were investigated. The quality of bowel preparation was assessed using the Boston bowel preparation scale （BBPS）. The correlation between walking function status and compliance or quality of bowel preparation was analyzed with the Spearman rank correlation test.Results The proportion of failing to completely take the intestinal cleanser was lower in the difficulty walking group than that in the normal walking group： 53.5% （46/86） vs. 26.3% （30/114）, and there was statistical difference （χ2= 15.362, P〈0.05）. The reasons for failing to completely take the intestinal cleanser in the difficulty walking group were as follows： unconvenient of frequently walking to the restroom to defecate （39 cases）, forgetting （4 cases） and adverse reactions （3 cases）. The good proportion of bowel preparation compliance and sufficient rate of bowel preparation in difficulty walking group were significantly lower than that in normal walking group： 41.9% （36/86） vs. 65.8% （75/114） and 55.8% （48/86） vs. 72.8% （83/114）, and there were statistical differences （χ2= 11.365 and 6.264, P〈0.01 or〈0.05）. There was no significant difference between 2 groups in the constituent ratio of strictly implementing the bowel preparation program （P〉0.05）. The correlation analysis result showed that the walking function status was positively correlated with compliance and quality of bowel preparation in the elderly patients （r= 0.238 and 0.177, P〈0.05）.Conclusions The walking function status is correlated to the quality of bowel preparation in elderly patients undergoing colonoscopy. Difficulty walking may indicate the poor compliance and poor colonoscopy preparation in the aged.