药学服务模式下门诊结肠镜检查前肠道准备质量的影响因素分析

Analysis of influencing factors of bowel preparation quality before outpatient colonoscopy under the model of pharmaceutical care

目的探讨药学服务模式下影响结肠镜肠道准备质量的因素。方法采用随机数字表法抽取2018年1月至2019年4月656例在南京大学医学院附属鼓楼医院行门诊结肠镜检查的患者进行肠道准备教育,检查当天通过面对面问卷采集患者基础信息及依从性信息,问卷回收率为94.36%,应用单因素方差分析和多因素logistic回归分析肠道准备失败的影响因素。结果不同年龄、是否诊断为高血压、糖尿病患者左半结肠评分比较,差异有统计学意义(P<0.05);是否诊断为高血压患者横结肠评分比较,差异有统计学意义(P<0.05);不同性别、不同文化程度、是否诊断为高血压患者右结肠评分比较,差异有统计学意义(P<0.05);不同年龄、是否诊断为高血压患者总评分比较,差异有统计学意义(P<0.05)。高血压(OR=2.453,95%CI:1.284~4.684)和肠道准备依从性(OR=2.160,95%CI:1.118~3.987)是整体肠道准备评分的影响因素(P<0.05);高血压(OR=8.880,95%CI:3.552~22.201)是影响左半结肠肠道准备评分的因素(P<0.05);教育程度(OR=0.657,95%CI:0.445~0.970)是右半结肠评分的影响因素(P<0.05)。结论高血压和受教育程度低是结肠镜检查肠道准备失败的预测因素。

Objective To explore the influencing factors the quality of colonoscopy bowel preparation under the pharmaceutical care model.Methods From January 2018 to April 2019,a total of 656 outpatients for colonoscopy received education of bowel preparation by pharmacists.Questionnaires were filled out by pharmacists on the day of undergoing colonoscopy with effective recovery of 94.36%.Then univariate and multivariate logistic regression analysis were applied to analyze factors influencing bowel preparation.Results There were statistically significant differences in the left colon scores of patients with different ages,whether they were diagnosed with hypertension,or diabetes(P<0.05);whether it was diagnosed as hypertensive patients with transverse colon score comparison,and the difference was statistically significant(P<0.05);there were statistically significant differences in the right colon scores of patients with different genders,different educational levels,and whether they were diagnosed with hypertension(P<0.05);there were statistically significant differences in the total scores of patients of different ages and whether they were diagnosed with hypertension(P<0.05).Hypertension(OR=2.453,95%CI:1.284-4.684)and bowel preparation compliance(OR=2.160,95%CI:1.118-3.987)were the influencing factors of the overall bowel preparation score(P<0.05);hypertension(OR=8.880,95%CI:3.552-22.201)was the influencing factor of the score of left colon bowel preparation(P<0.05);education level(OR=0.657,95%CI:0.445-0.970)was the influencing factor of the score of the right colon(P<0.05).Conclusion High blood pressure and low education are predictors of failure of bowel preparation for colonoscopy.