联合无痛胃肠镜检查患者的肠道准备策略  

Bowel preparation strategy for patients undergoing painless gastroscopy combined with colonoscopy

作　　者：杨龙宝[1] 赵刚[1] 安苗[1] 秦赟 薛琼 王进海[1] 董蕾[1] Yang Longbao;Zhao Gang;An Miao;Qin Yun;Xue Qiong;Wang Jinhai;Dong Lei(Department of Gastroenterology,Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院消化内科,710004

出　　处：《中华结直肠疾病电子杂志》2021年第3期278-283,共6页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：陕西省科技计划重点研发项目(No.2017ZDXM-SF-046)。

摘　　要：目的探讨联合无痛胃肠镜检查患者肠道准备的优化方案,为提高肠道准备的质量及肠镜下结肠病变的检出率提供新的策略。方法以2016年9月至2017年5月就诊于西安交通大学第二附属医院行联合无痛胃肠镜检查的120名健康人群为研究对象,以随机分组的方式分为观察组与对照组,两组人群均常规服用泻剂,观察组加用全消化道动力药(莫沙必利),比较两组人群的肠镜操作时间、回肠插管率、肠道清洁评分(Boston评分量表法)、肠息肉及其他疾病检出率;同时比较不同服药时间的同组人群的上述各项观察指标。结果观察组人群的结肠镜操作时间明显少于对照组(11.6±2.8 min vs. 16.4±3.2 min,t=6.26,P<0.05);肠道清洁度方面:观察组与对照组中肠道准备良好的比例分别为83.3%及53.3%,两组间差异有统计学意义(χ^(2)=4.38,P<0.05);在以服药时间为观察对象的亚组比较中,尽管观察组中检查前10 h服药与检查前12 h、8 h服药在肠道准备良好率方面总体上差异无统计学意义(χ^(2)=3.120,P=0.210),但检查前10 h开始服药人群的肠道准备良好率最高,为95%;对照组方面,检查前8 h、10 h和12 h服药的肠道准备良好率,三组之间总体上差异有统计学意义(χ^(2)=8.973,P=0.011),其中,仍然是检查前10 h开始服药人群的肠道准备良好率最高,为80%,并且与检查前12 h服药组间的差异具有统计学意义(χ^(2)=8.286,P=0.004);两组间在回肠插管率方面差异无统计学意义(分别为100%和98.3%);观察组的肠息肉及其他疾病检出率显著优于对照组(46.7%vs. 18.3%,χ^(2)=3.90;P<0.05)。结论加用全消化道动力药物有助于改善联合无痛胃肠镜检查患者的肠道清洁度及肠道病变的检出率。联合无痛胃肠镜检查患者在检查前10 h服用泻剂有获得更好的肠道清洁度的可能。Objective To explore the optimal scheme of bowel preparation for patients undergoing painless gastroscopy combined with colonoscopy,so as to provide a new strategy for improving the quality of bowel preparation and detection rate of colon lesions under colonoscopy.Methods From September 2016 to May 2017,120 healthy people who underwent combined painless gastrointestinal endoscopy in the Second Affiliated Hospital of Xi’an Jiaotong University were selected as the research objects.They were randomly divided into observation group and control group.The two groups were given laxatives regularly,while the observation group was given total decontamination drug(Mosapride).The operation time of colonoscopy,ileum intubation rate,colon cleanliness(Boston score),detection rate of colonic polyps and other diseases were compared between the two groups.At the same time,the above observation indexes in the same group of people with different medication time were compared.Results The operation time of colonoscopy in the observation group was significantly shorter than that in the control group(11.6±2.8 min vs.16.4±3.2 min,t=6.26;P<0.05).In terms of colon cleanliness,83.3%of the observation group and 53.3%of the control group had good bowel preparation(χ^(2)=4.38,P<0.05).Among the subgroups taking the medication time as the observation object,in observation groups,there were no significant difference in the intestinal preparation rate between taking medicine 10 h before examination and taking medicine 12 h and 8 h before examination(χ^(2)=3.120,P=0.210),but the intestinal preparation rate of the people taking medicine 10 h before examination was the highest(95%);In control groups,the intestinal preparation rates of taking medicine 8,10 and 12 hours before examination were different(χ^(2)=8.973,P=0.011),among them,the intestinal preparation rate of the people taking medicine 10 hours before examination was the highest,which was 80%,and the difference between the two groups(10 h vs 12 h)was statistically significant(χ^(2)=8

关 键 词：结肠 结肠镜检查 肠道准备 莫沙必利 服药时间 

分 类 号：R574.62[医药卫生—消化系统]