结肠镜检查前肠道准备质量的影响因素分析

Analysis of Factors Influencing the Colonoscopy Preparation Quality

目的:探讨肠道准备不充分的影响因素,对肠道准备的用药指导进行设计及优化,实现结肠镜患者检查前聚乙二醇(PEG)的个体化给药,提高肠道准备质量。方法:采用前瞻性研究方法,对2017年2~5月在我院准备行结肠镜检查的门诊患者进行问卷调查,并采用波士顿评分量表评价肠道准备质量,用单变量分析与多因素Logistic回归分析肠道准备不充分的影响因素。结果:共有197例门诊患者完成问卷调查,其中肠道准备充分的患者达61.4%。单因素分析结果显示,年龄、高血压、长期服用药物、末次大便性状、检查前一天纤维素摄入情况为导致肠道准备不充分的影响因素(P<0.05)。多因素Logistic回归分析结果显示,相对较高的年龄[OR=0.95,95%CI(0.92,0.97)]、服用药物[OR=0.35,95%CI(0.13,0.94)]、末次排出极少粪渣[OR=0.13,95%CI(0.06,0.30)]、检查前一天进食高纤维饮食[OR=0.23,95%CI(0.10,0.54)]是肠道准备不充足的独立危险因素。结论:相对较高的年龄、服用药物、末次排出极少粪渣、检查前一天进食高纤维饮食是患者肠道准备不充分的独立危险因素。

Objective： To find out the influencing factors of inadequate intestinal preparation and to integrate,to design and optimize the guidance of intestinal preparation,and to improve the quality of intestinal preparation by individualized administration of polyethylene glycol（PEG） before the examination of colonoscopy patients through pharmacist intervention. Methods： Single-center,prospective observational study method was used. A questionnaire was administered to the patients who underwent colonoscopy in the out-patient department between February 2017 and May 2017. Bowel preparation was assessed using Boston bowel preparation scale（BBPS） score. Univariate and multivariate Logistic regression analysis were performed for the influencing factors for the inadequate preparations. Results： A total of 197 patients participated in the study. The proportion of adequate intestinal preparations was 61. 4%. The results of univariate analysis showed that the age,hypertension,drugs,character of stool before colonoscopy,high fiber diet during the 24 h period immediately preceding colonoscopy were associated with inadequate intestinal preparation（P〈0. 05）. The results of multivariate logistic regression analysis showed that the older age [OR = 0. 95,95% CI（0. 92,0. 97） ],take medicine [OR = 0. 35,95%CI（0. 13,0. 94） ],character of stool before colonoscopy [OR = 0. 13,95% CI（0. 06,0. 30） ],high fiber diet during the24 h period immediately preceding colonoscopy [OR = 0. 23,95% CI（0. 10,0. 54） ]were independent risk factors for inadequate intestinal preparation. Conclusion： Advanced age,take medicine,character of stool before colonoscopy and high fiber diet predict poor bowel preparation were independent risk factors for inadequate bowel preparation.