老年患者结肠镜检查前不同肠道准备效果观察

Different intestinal preparations of colonoscopy in gerontal patients

目的探讨老年患者结肠镜检查前不同肠道准备方式的肠道清洁效果、安全性及耐受性。方法选择自2016年1月至2017年1月在解放军105医院拟行纤维电子结肠镜检查的老年患者390例,采用随机数字表法分为3组,每组各130例患者。结肠镜检查前进行清理肠道,A组给予口服复方聚乙二醇电解质散,B组给予口服单瓶磷酸钠盐口服溶液联合乳果糖,C组给予口服硫酸镁口服液。通过波士顿肠道准备量表(BBPS)评分、肠腔内气泡评分评价各组患者肠道清洁度,通过患者对药物口感、是否愿意再次服用情况评价其耐受度,并观察不良反应情况。结果 A组、B组BBPS评分明显优于C组,差异有统计学意义(P<0.05),但A组与B组间BBPS评分无明显差异。B组肠腔内气泡评分明显优于A组与C组,视野更清晰,差异有统计学意义(P<0.05)。药物口感、愿意再次服用方面,B组患者明显多于A组与C组,差异有统计学意义(P<0.05)。服药后不良反应,B组明显少于A组、C组,差异有统计学意义(P<0.05)。结论老年患者采用单瓶磷酸钠盐口服溶液联合乳果糖进行肠道准备,可适当减少患者饮水量,患者依从性高,不良反应少,肠道清洁度好,有助于发现微小病变,降低结肠镜检查的漏诊率。

Objective To investigate the intestinal cleaning effect,security and toleration on different intestinal preparations of colonoscopy in gerontal patients. Methods A retrospective study was performed on 390 cases of gerontal patients who underwent electronic colonoscopyfrom January 2016 to January 2017. Patients were randomly divided into 3 groups with 130 cases in each group. The intestines were cleaned up before colonoscopy,patients in Group A were given polyethylene glycol electrolyte powder; patients in Group B were given single sodium phosphate oral solution combined with lactulose solution; patients in Group C were givenmagnesium sulfate oral solution. The toleration was evaluated by drug taste and whether or not willing to once again use drug; intestinal tract cleanness was evaluated by Boston Bowel Preparation Scale（ BBPS） score and intestinal foam score,and the adverse reaction was observed.Results BBPS scores in Group A and Group B were significantly better than that in Group C（ P〈0. 05）,there was no significant difference of BBPS between Group A and Group B. The intestinal foam of Group B was significantly less than that of Group A and Group C,and the field of view of Group B was clearer（ P〈0. 05）. The number of patients who accepted the drug taste and willed to take the drug once more was significantly more than that in Group A and Group C（ P〈0. 05）. The adverse reaction of Group B was significantly less than that of Group A and Group C（ P〈0. 05）. Conclusion The bowel preparation method which combined single sodium phosphate oral solution with lactulose solution ingerontal patientsis safe and effective,which could reduce the water-drinking amount and the adverse reaction,improve compliance and intestinal tract cleanness of patients. The method is conductive to the discovery of minute lesions of intestinal tract,and reducing the rate of missed diagnosis of colonoscopy.