判断末次大便性状对胶囊内镜肠道清洁质量的影响

The rectal effluent based on the photographs can improve the quality of bowel cleanliness of the capsule endoscopy

目的探讨由专业医务人员通过照片评估末次大便性状并指导泻药使用对胶囊内镜肠道清洁质量的影响。方法选取2016年1月-2019年3月该院行胶囊内镜的患者64例,分为实验组(医务人员判断组,n=21)和对照组(患者自我判断组,n=43),比较两组患者肠道清洁质量和小肠病变诊断阳性率。结果实验组追加泻药人数多于对照组(23.81%和4.65%,P=0.005)。定量评价中,实验组全小肠清洁度和远端小肠清洁度均优于对照组[(9.52±0.68)和(8.49±1.41)分,P=0.001;(8.19±1.21)和(6.84±1.83)分,P=0.002]。定性评价中,实验组全小肠清洁度优3例,良11例,一般7例,差0例;对照组优4例,良20例,一般10例,差9例,实验组优于对照组(P=0.003);实验组远端小肠清洁度优2例,良1例,一般16例,差2例;对照组优2例,良14例,一般6例,差21例,实验组优于对照组(P=0.018)。总体充分度评估中,实验组充分17例,不充分4例;对照组充分20例,不充分23例,实验组优于对照组(P=0.005)。R/G比值积分(R/G红色强度与绿色强度的比值)中,实验组全小肠清洁度和远端小肠清洁度均优于对照组[(6.08±0.80)和(5.52±0.94),P=0.014;(5.67±0.79)和(5.11±1.04),P=0.021]。实验组全小肠疾病诊断阳性率为81.00%,对照组为74.41%,实验组高于对照组,但两组比较差异无统计学意义(P=0.531);实验组远端小肠病变诊断阳性率高于对照组(47.62%和23.26%,P=0.026)。结论由专业医务人员通过照片评估末次大便性状并指导泻药使用,可提高胶囊内镜的肠道清洁质量,方法简单,临床实用价值高。

Objective To explore the effect of medical staff evaluate the last rectal effluent and guide the use of laxatives on the bowel cleanliness quality of capsule endoscope.Methods The patients who underwent capsule endoscopy from January 2016 to March 2019 were divided into group experimental group(medical staff-judgment group,n=21)and control group(patient self-judgment group,n=43).Compare the quality of bowel cleanliness and the positive rate of diagnosis of intestine disease in the two groups.Results The number of additional laxatives in the experimental group was more than that in the control group(23.81%and 4.65%,P=0.005).In the quantitative evaluation,the cleanness of the whole small intestine and the cleanliness of the distal small intestine of the experimental group were better than those of the control group[(9.52±0.68)and(8.49±1.41),P=0.001;(8.19±1.21)and(6.84±1.83),P=0.002].In the qualitative evaluation,the cleanness of the whole small intestine of the experimental group was excellent in 3 cases,good in 11 cases,fair in 7 cases,and poor in 0 cases,the control group was excellent in 4 cases,good in 20 cases,fair in 10 cases,and poor in 9 cases,the experimental group was better than the control group(P=0.003);The distal small intestine cleanliness of the experimental group was excellent in 2 cases,good in 1 case,fair in 16 cases,poor in 2 cases,in the control group was excellent in 2 cases,good in 14 cases,fair in 6 cases,poor in 21 cases,and the experimental group was better than the control group(P=0.018).In the overall adequacy assessment,17 cases were adequate in the experimental group,4 cases were inadequate,20 cases were adequate in the control group,and 23 cases were insufficient.The experimental group was better than the control group(P=0.005).In the R/G ratio integral(R/G red intensity to green intensity ratio),the cleanness of the whole small intestine and the cleanliness of the distal small intestine of the experimental group are better than those of the control group[(6.08±0.80)and(5.52±0.94),P=0.014;(5.67±0.79)and(5.11±1.04),P=0.021].The positive rate of diagnosis of total small bowel disease in the experimental group was 81.00%,and that in the control group was 74.41%.The experimental group was higher than the control group,but the difference between the two groups was not statistically significant(P=0.531).The positive rate of diagnosis of distal small bowel disease in the experimental group was higher than the control group(47.62%and 23.26%,P=0.026).Conclusion The medical staff evaluate the final rectal effluent characteristics through photos and guide the use of laxatives to improve the quality of bowel cleanliness of capsule endoscopy.The method is simple and has great clinical practical value.