结肠镜检查前不同宣教模式对肠道清洁效果的影响

Effect of different propaganda and education modes on intestinal cleanliness before colonoscopy

目的探讨结肠镜检查前不同宣教模式对肠道清洁效果的影响。方法选择2018年6月1日至2018年10月31日于首都医科大学附属北京友谊医院内镜中心行结肠镜检查的全部患者,在结肠镜检查前对门诊患者、日间病房患者和住院患者采用对应的宣教模式,对三组人群的相关内镜检查资料包括波士顿肠道准备量表(Boston bowel preparation scale,BBPS)评分、肠道气泡评分(bowel bubble scale,BBS)、病变描述等进行分析和比较。结果研究期间全部患者接受结肠镜检查共计5498例次,其中4940例次纳入统计分析。门诊患者BBPS评分不合格(1~5分)、中等(6分)的比例分别为21.6%、25.3%,高于日间病房患者(13.1%、18.5%)及住院患者(9.8%、19.1%),差异有显著性(P<0.05);门诊患者BBPS评分良好(7~8分)、最佳(9分)的比例分别为47.0%和6.2%,低于日间病房患者(56.4%、12.1%)及住院患者(53.4%、17.7%),差异有显著性(P<0.001)。门诊患者BBS 0分(无气泡)的比例为31.3%,显著低于日间病房(47.5%)及住院患者(53.2%);BBS 1、2、3分的比例分别为38.2%、21.3%、9.2%,显著高于日间病房及住院患者,差异有显著性(P<0.001)。结论与传统宣教模式相比,自身服药经验及护士全程监管下服用肠道清洁剂可显著提高肠道清洁的质量。应重视宣教对肠道清洁的影响,以提高肠道清洁质量,进而提升结肠镜检查的质量。

Objective Explore the effect of different propaganda and education modes on intestinal cleanliness before colonoscopy.Method Colonoscopy data were collected from the Endoscopic Center of Beijing Friendship Hospital Affiliated to Capital Medical University from June 1,2018 to October 31,2018,including Boston Bowel Preparation Scale(BBPS),Bowel Bubble Scale(BBS)and description of lesions.Patients were divided into outpatients,day ward patients and inpatients,according to the different propaganda and education modes before colonoscopy.Endoscopic data of the three groups were analyzed and compared.Result 5498 patients underwent colonoscopy during the study period and we finally enrolled 4940 patients.The outpatients with unqualified BBPS score(1-5 points)and moderate BBPS score(6 points)were 21.6%and 25.3%respectively,which were significantly higher than those in day ward patients(13.1%and 18.5%)and inpatients(9.8%and 19.1%),and the results showed statistical differences(P<0.001).The outpatients with good BBPS score(7-8 points)and best BBPS score(9 points)were 47.0%and 6.2%,significantly lower than those in day ward patients(56.4%and 12.1%)and inpatients(53.4%and 17.7%),and the results showed statistical differences(P<0.001).For BBS of 0(no bubbles),the percentage was 31.3%in outpatients,significantly lower than that in day ward patients and inpatients(47.5%and 53.2%);for BBS of 1-3(a small amount of bubbles-a large number of bubbles),the percentage were up to 38.2%,21.3%and 9.2%respectively in the outpatients,significantly higher than those in day ward patients and inpatients.The BBS differences were also statistically significant(P<0.001).Conclusion Compared with the traditional mode,to strengthen propaganda and education by self-medication experience and under the supervision of nurses can significantly improve the level of intestinal cleanliness.Attention should be paid more to propaganda and education on intestinal Cleanliness,so as to improve the quality of intestinal cleanliness and thereby improve the quality of colonoscopy.