乳果糖在老年便秘患者结肠镜检查中的应用及相关影响因素分析  

Application of lactulose oral solution in colonoscopy in elderly patients with constipation and analysis of related influencing factors

作　　者：韩旭莉 胡远超 郭伟[3] 徐博[3] 雷鸣 王琼瑶 HAN Xuli;HU Yuanchao;GUO Wei;XU Bo;LEI Ming;WANG Qiongyao(Department of Clinical Medicine,Xi′an Medical University,Xi′an 710021,China;Health Center of Shigou Town,Qianyang County,Baoji;Department of General Medicine,Shaanxi Provincial People′s Hospital)

机构地区：[1]西安医学院,陕西西安710021 [2]宝鸡市千阳县柿沟镇卫生院 [3]陕西省人民医院全科医学科

出　　处：《沈阳医学院学报》2020年第3期243-246,共4页Journal of Shenyang Medical College

摘　　要：目的:探讨乳果糖在老年便秘患者结肠镜检查中的应用及相关影响因素分析。方法:前瞻性纳入2018年1月至10月在某省医院行普通结肠镜检查的老年便秘患者87例,随机分为使用复方聚乙二醇(PEG)+乳果糖组及单纯使用PEG组,2组均分次给予复方聚乙二醇电解质溶液(PEG-SEL)1.5 L,其中PEG+乳果糖组患者在结肠镜检查前4 h口服乳果糖100 ml,采用Boston肠道量表进行肠道清洁的评分,对所有纳入研究患者的性别、年龄、吸烟、体重指数、文化程度、肠镜检查史、末次进食食物的种类及末次进食与口服泻药的间隔时间进行二元Logistic回归分析。结果:PEG+乳果糖组肠道清洁质量(BBPS)、腺瘤检出率及进镜时间方面与PEG组比较差异有统计学意义(P<0.05),二元Logistic回归分析显示肠道准备方法、体重指数值及末次进食与口服泻药的间隔时间均为影响老年便秘患者肠道准备质量的独立危险因素(P<0.05)。结论:在结肠镜检查中应用PEG和乳果糖可以显著提高老年便秘患者的肠道准备的清洁质量,同时老年便秘患者预防性减轻体重,增加末次进食与口服泻药的间隔时间可以改善患者肠镜检查的质量。Objective:To investigate the application of lactulose oral solution in colonoscopy in elderly patients with constipation and analyze the related influencing factors.Methods:A total of 87 cases of elderly patients with constipation who underwent colonoscopy in a provincial hospital from Jan 2018 to Oct 2018 were enrolled prospectively,and were randomly divided into polyethylene glycol(PEG)+lactulose group(40 cases)and PEG group(47 cases).In the evening prior to the day of colonoscopy and in the morning of the colonoscopy,cases in both groups received 1.5 L PEG electrolyte solution.The PEG+lactulose group received 100 ml lactulose oral solution at 4 h before colonoscopy.The Boston bowel preparation scale(BBPS)was used to evaluate the bowel cleanliness.The gender,age,smoking,body mass index(BMI),education level,colonoscopy history,the type of food eaten the day before the colonoscopy,and the interval between last feeding and oral laxatives was analyzed with binary Logistic regression analysis.Results:Compared with the PEG group,there was significant improvement in bowel cleanliness,the adenoma detection rate(ADR)and the enteroscopy time in the PEG+lactulose group(P<0.05).Binary Logistic regression analysis showed that intestinal preparation,BMI and the interval between last feeding and oral laxatives were independent risk factors affecting the quality of intestinal preparation in elderly patients with constipation(P<0.05).Conclusion:The application of lactose and PEG in colonoscopy in elderly patients with constipation can significantly improve the bowel cleanliness,and the preventive weight loss and the increase of the interval between last feeding and oral laxatives can improve the quality of colonoscopy.

关 键 词：乳果糖 老年患者 便秘 肠镜检查 

分 类 号：R574[医药卫生—消化系统]