门诊结肠镜检查病人肠道准备的药学服务实践

Pharmaceutical service practice of intestinal preparation for outpatient colonoscopy patients

目的研究药学服务对病人结肠镜检查前肠道准备的焦虑状况、用药安全及肠道清洁度的影响。方法由药学技术人员采用随机数字表法对南京鼓楼医院2018年3—4月门诊结肠镜检查病人142例进行清肠准备教育,作为试验组;同期采用随机数字表法将调查的113例作为对照组,仅接受肠镜室预约单上的简单指导。调查对照组与试验组病人的焦虑状况以及肠道清洁度。结果试验组焦虑程度轻于对照组["没有焦虑""可能有焦虑""肯定有焦虑""肯定有明显焦虑""可能为严重焦虑":(14,81,44,3,0)比(10,18,58,27,0),Z=-6.591,P<0.001]。试验组肠道清洁度优于对照组["差""中""良""优":(6,13,88,35)比(17,42,45,9),Z=-6.503,P<0.001]。试验组头晕、恶心、呕吐不良反应发生率低于对照组(χ^2值分别为6.113,8.046,5.209,P值分别为0.013,0.005,0.022)。试验组服药时间、服药频次、服药总量(含液体)、饮食控制依从性均高于对照组(χ^2值分别为6.553,12.938,13.570,14.959,P值分别为0.010,<0.001,<0.001,<0.001)。结论药学技术人员为门诊结肠镜检查病人提供个体化肠道准备教育,能够减轻病人焦虑状况,提高肠道清洁度,保障病人用药安全。

Objective To study the effects of pharmaceutical care on anxiety,medication safety and intestinal cleanliness of patients before colonoscopy.Methods A total of 142 outpatients undergoing colonoscopy in Nanjing Drum Tower Hospital from March to April 2018 were enrolled via the random number table method by pharmacists as the experimental group.At the same time,113 cases were enrolled via the random number table method as control group,and only received simple instruction on the ap⁃pointment list.The anxiety status and intestinal cleanliness of the patients in the control group and the experimental group were in⁃vestigated.Results The anxiety level of the experimental group was lighter than that of the control group["no anxiety","may have anxiety","definitely have anxiety","definitely have obvious anxiety",and"may be severe anxiety":(14,81,44,3,0)vs.(10,18,58,27,0),Z=-6.591,P<0.001].The intestinal cleanliness of the experimental group was better than that of the control group["poor","medium","good"and"excellent":(6,13,88,35)vs.(17,42,45,9),Z=-6.503,P<0.001].The incidence of ADR of diz⁃ziness,nausea and vomiting in the experimental group was lower than that in the control group(χ^2=6.113,8.046,5.209;P=0.013,0.005,0.022).The compliance of medication time,frequency,total dosage(including liquid)and diet⁃control in the experi⁃mental group was higher than that in the control group(χ^2=6.553,12.938,13.570,14.959;P=0.010,<0.001,<0.001,<0.001).Conclusion Pharmacy technicians provide individualized bowel preparation education for outpatients undergoing colonoscopy,which can relieve anxiety,improve intestinal cleanliness and ensure patients administration security.