儿童结肠镜术前肠道准备质量的影响因素

Analysis of the factors influencing the quality of bowel preparation for colonoscopy in children

目的评估行结肠镜检查术前患儿的肠道准备质量,并探讨其影响因素。方法前瞻性纳入2017年8月1日至2018年3月31日期间行结肠镜检查术的患儿198例。根据Boston肠道准备评分量表(The Boston Bowel Preparation Scale,BBPS)进行肠道准备质量评价,并收集患儿一般资料、肠道准备过程相关情况;采用有序logistic回归分析肠道准备质量的影响因素。结果纳入的198例患儿中,男116例、女82例;平均年龄(8.70±2.87)岁;总BBPS得分为(7.45±1.31)分。肠道准备清洁程度为优104例(52.5%),良74例(37.4%),差20例(10.1%);发生不良反应90例(45.5%)。清洁度优、良、差三组患儿之间便秘史,服药后大便次数,最后一次大便性状,不良反应,服药前、服药期间、服药后运动的差异均有统计学意义(P<0.05)。Logistic回归分析发现服药后大便次数少,最后一次大便性状为稀糊状、深黄色或褐色有渣、淡黄水样,服用泻药期间无运动和没有完全服用泻药是降低肠道准备清洁度的独立影响因素(P<0.05)。结论临床应早期识别影响肠道准备质量的相关因素,并及时采取相应干预措施,以提高肠道准备质量。

Objective To evaluate the quality of bowel preparation in children for colonoscopy and to explore the influencing factors.Methods A total of 198 children who underwent colonoscopy between August 1,2017 and March 31,2018 were included prospectively.According to the Boston Bowel Preparation Scale(BBPS),the quality of bowel preparation was evaluated,and the general information of the child and the relevant situation of the bowel preparation process were collected.Multivariate logistic regression analysis was preformed to analyze the influencing factors of bowel preparation quality.Results Among the 198 children(116 males and 82 females)with an average age of(8.70±2.87)years,a total BBPS score was(7.45±1.31).The cleanliness degree of bowel preparation was excellent in 104 cases(52.5%),good in 74 cases(37.4%),and poor in 20 cases(10.1%).The adverse reactions occurred in 90 cases(45.5%).There were statistically significant differences in the history of constipation,the number of stools after taking medicine,the last stool characteristics,adverse reactions,and the exercise before,during and after taking medicine among the three groups(P<0.05).Logistic regression analysis found that less frequency of stools after taking medicine,the last stool property(mushy stool,dark yellow or brown with residue or light yellow water),no exercise during taking laxatives and not taking laxatives completely were independent factors reducing the cleanliness of bowel preparation(P<0.05).Conclusions In order to improve the quality of bowel preparation,it is necessary to identify the relevant factors that affect the quality of bowel preparation in early stage and take corresponding interventions in time.