咀嚼口香糖联合右美托咪定滴鼻在结肠镜检查肠道准备及快速康复中的应用

Application of chewing gum combined with dexmedetomidine nasal drops in intestinal preparation and rapid rehabilitation of colonoscopy

目的探讨咀嚼口香糖联合右美托咪定滴鼻在结肠镜检查肠道准备及快速康复中的应用效果。方法本研究为临床对照试验,采用便利抽样法选择2019年1月至2020年12月在绍兴第二医院行无痛结肠镜检查的患者126例为研究对象。按照随机数字表法将患者分为对照组和观察组,每组63例。对照组采取常规结肠镜检查前的准备方法并给予右美托咪啶滴鼻,观察组在对照组基础上联合给予咀嚼口香糖的干预。对比2组患者的肠道清洁度、肠道内祛泡效果、结肠镜操作耗时(插镜耗时、退镜耗时)、排便情况(术后首次排便时间、术前大便排空时间)及结肠镜检查过程中的不良反应情况。结果干预前,2组患者一般资料比较差异均无统计学意义(均P>0.05)。干预后观察组的右半结肠、横结肠、左半结肠的清洁度评分分别为(2.12±0.58)、(2.23±0.75)、(2.18±0.46)分,均高于对照组的(1.82±0.63)、(1.93±0.72)、(1.90±0.81)分,差异均有统计学意义(t=-2.78、-2.29、-2.39,均P<0.05),观察组的肠道内祛泡效果评分为(1.12±0.41)分,低于对照组的(1.87±0.45)分,差异有统计学意义(t=9.78,P<0.05)。干预后观察组的插镜耗时、术后首次排便时间及术前大便排空时间分别为(5.46±1.12)、(50.36±10.67)、(141.03±14.31)min,均低于对照组的(6.53±1.25)、(67.02±11.25)、(153.35±17.32)min,差异均有统计学意义(t=5.06、8.53、4.35,均P<0.05);2组的退镜耗时和不良反应情况比较差异均无统计学意义(t=1.49、χ^(2)=0.00,均P>0.05)。结论咀嚼口香糖联合右美托咪定滴鼻的方法可以提升结肠镜检查患者的肠道准备的效果,促进检查后的康复,不引起不良反应风险增高。

Objective To explore the application effect of chewing gum combined with dexmedetomidine nasal drops in colonoscopy intestinal preparation and rapid rehabilitation.Methods Using the method of clinical controlled trial and convenient sampling,126 patients who underwent painless colonoscopy in Shaoxing Second Hospital from January 2019 to December 2020 were selected as the study subjects.The patients were divided into control group and observation group with 63 cases in each group by random number table method.The control group was prepared for routine colonoscopy,and the observation group was intervened with chewing gum on the basis of the operation method of the control group.The intestinal cleanliness,the effect of removing bubbles in the intestinal tract,the time consuming of colonoscopy operation(time consuming of inserting the colonoscope and time consuming of removing the colonoscope),defecation(time consuming of first defecation after operation,time consuming of stool emptying before operation)and adverse reactions during colonoscopy were compared between the two groups.Results Before the intervention,there was no significant difference in the general data between the two groups(P>0.05).After intervention,the cleanliness scores of the right colon,transverse colon and left colon in the observation group were(2.12±0.58)points,(2.23±0.75)points and(2.18±0.46)points respectively,which were higher than those of the control group(1.82±0.63)points,(1.93±0.72)points and(1.90±0.81)points,with a statistically significant difference(t=-2.78,-2.29,-2.39,all P<0.05).The score of the effect of removing bubbles in the intestine in the observation group was(1.12±0.41)points,it was lower than that of the control group(1.87±0.45)points,and the difference was statistically significant(t=9.78,P<0.05).After intervention,the time of inserting the mirror,the time of first defecation after operation and the time of emptying stool before operation in the observation group were(5.46±1.12)min,(50.36±10.67)min and(141.03±14.31)min respectively,which were lower than those in the control group(6.53±1.25)min,(67.02±11.25)min and(153.35±17.32)min,and the difference was statistically significant(t=5.06,8.53,4.35,all P<0.05).There was no statistically significant difference between the two groups in the time of withdrawing the mirror(P>0.05)and adverse reactions(t=1.49,χ^(2)=0.00,both P>0.05).Conclusions Chewing gum combined with dexmedetomidine nasal drip can improve the effect of intestinal preparation and promote the rehabilitation after colonoscopy without increasing the risk of adverse reactions.