图示法宣教对结肠镜检查患者肠道准备质量影响的研究

The clinical study of the effect of graphical education on the quality of bowel preparation in patients undergoing colonoscopy

目的探索和研究图示法宣教对结肠镜检查患者肠道准备质量的影响。方法选取2016年1月～2017年6月在武警陕西总队医院拟行结肠镜检查的患者260例,按照随机数表法分为图示组和常规组,各130例,采用前瞻性、双盲、对照研究。图示组将涉及的复杂医学专业知识(肠道准备操作步骤及正确的粪水性状等)用形象简单的图示直观地告知患者,常规组则应用传统的宣教模式交代肠道准备事项,比较两种方法对肠道准备质量的影响。结果图示组的肠道准备合格率高于常规组(88.5%vs 75.4%,P=0.006),按Boston肠道清洁度评分准则,图示组总评分及左、右侧结肠评分均优于常规组(P <0.05),但中间结肠评分两者无明显差异;两组患者进镜时间无差别,但图示组的退镜时间低于常规组(P=0.008)。息肉检出率比较,图示组显著高于常规组(P=0.016)。图示组恶心、腹痛等不良反应发生率更低(P <0.05),且睡眠质量更好(72.3%vs 59.2%,P=0.026)。结论图示法宣教可以提高患者肠道准备质量,并可以明显增加息肉检出率及患者舒适度。

Objective To study the effect of graphical education on the quality ot bowel preparation in patients undergoing colonoscopy. Methods 260 patients who scheduled colonoscopy were randomly divided to graphical education group and traditional education group . The study was conducted in a prospective,double-blind,controlled method. Results Based on Ottawa scale,the rate of adequate bowel cleansing is significantly higher in the graphical group than that in the traditional group （88.5% vs 75.4%, P= 0.006）. The scores of the total colon, right colon and left colon were statistically higher in graphical group than those in the traditional group （P all 〈 0.05）. no significant difference was found involving the middle segment. The mean withdrawal time of graphical group was significantly shorter than that of traditional group （P=0.008）. Higher polyps detection rate was observed in graphical group. Compared with traditional group,less patients in graphical group reported nausea （21.5% vs 35.4%, P=0.013） and abdominal pain （8.6% vs 17.4%,P=0.029）. More patients reported excellent or good sleep quality in graphical group （72.3% vs 59.2%,P=0.026）. Conclusion Graphical education improved bowel preparation quality,polyps detection rate and patient comforts.