老年患者结肠镜检查前肠道准备失败危险因素分析及护理策略优化

Analysis of risk factors for bowel preparation failure before colonoscopy in elderly patients and optimization of nursing strategies

目的探讨老年结肠镜检查患者肠道准备失败的危险因素,优化老年患者结肠镜检查前肠道准备流程。方法选取我院2022年1-12月收治的100例拟行结肠镜检查的60岁以上肠息肉患者为研究对象,使用Boston肠道准备量表(boston bowel preparation scale,BBPS)评估患者的肠道准备效果,依据肠道准备质量,将患者分为肠道准备成功组和失败组,采用logistic回归分析确定肠道准备失败的独立危险因素,基于老年患者肠道准备失败风险因素提出优化护理流程。结果logistic回归分析结果显示,年龄>65岁、BMI≥24 kg/m^(2)、高中以下学历、便秘是老年患者肠道准备失败的独立危险因素,大专以上学历和首次进行结肠镜检查是保护因素。肠道准备过程中灭菌注射用水冲洗量对准备效果具有决定性影响。由此提出匀浆无渣饮食结合营养液补充、复方电解质散用量逐次递增的优化护理流程。结论依据老年患者优化肠道准备的操作流程,不仅能够提高患者的肠道准备效果,还可有效降低肠道准备不良反应发生的风险,改善老年患者肠道准备质量,提高临床工作效率。

Objective To explore the risk factors of bowel preparation failure in elderly patients with colonoscopy,and to optimize the process of bowel preparation for elderly patients before colonoscopy.Methods A total of 100 cases of intestinal polyp patients over 60 years old who were to undergo colonoscopy admitted to our hospital from January to December 2022 were selected as the study subjects,and the bowel preparation effect of the patients was assessed using the Boston bowel preparation scale(BBPS),and based on the quality of bowel preparation,the patients were classified into bowel preparation success and failure groups,and logistic regression analysis was used to determine the independent risk factors for bowel preparation failure,and optimization of the nursing process was proposed based on the risk factors for bowel preparation failure in elderly patients.Results The results of logistic regression analysis showed that age>65 years,BMI≥24 kg/m^(2),education below high school,and combined constipation were independent risk factors for failure of bowel preparation in elderly patients,whereas high education and first colonoscopy were protective factors.The amount of saline rinse during bowel preparation had a decisive effect on the preparation effect.Thus,the optimized nursing process of a non-residue diet combined with nutrient supplementation and compound electrolyte dispersions in increasing dosages was proposed.Conclusion This study optimizes the operation process of bowel preparation according to the characteristics of elderly patients,which not only can improve the effect of bowel preparation,but also is expected to effectively reduce the risk of adverse reactions of bowel preparation,improve the quality of bowel preparation for elderly patients,and improve the efficiency of clinical work.