结肠镜检查前候诊时间对住院老年患者肠道准备质量的影响  

Effect of waiting time before colonoscopy on bowel preparation quality in hospitalized elderly patients

作　　者：荀林娟 吴哓哓 宋瑞梅[1] 周姝[1] 施雁[1] 庄英[1] 黄婷霞 居海岭 任万燕 陆天凤 陈炜[1] 江黎 Xun Linjuan;Wu Xiaoxiao;Song Ruimei;Zhou Shu;Shi Yan;Zhuang Ying;Huang Tingxia;Ju Hailing;Ren Wanyan;Lu Tianfeng;Chen Wei;Jiang Li(Department of Digestive Diseases,the Tenth People′s Hospital,Tongji University,Shanghai 200072,China;School of Nursing,Shangqiu Medical College,Shangqiu 476299,China)

机构地区：[1]同济大学附属第十人民医院消化内科,上海200072 [2]商丘医学高等专科学校护理学院,商丘476299

出　　处：《中国实用护理杂志》2022年第18期1375-1382,共8页Chinese Journal of Practical Nursing

基　　金：国家自然科学基金面上项目(71774117);上海市第十人民医院2021年专科护理人才项目(SYZKHLRC-B15)。

摘　　要：目的探讨住院老年患者肠道准备质量的影响因素,寻求老年患者肠道准备结束至开始检查的最佳候诊时间。方法收集同济大学附属第十人民医院2021年2—8月60岁以上需住院行结肠镜检查的老年患者资料。应用多因素分析筛选可能影响住院老年患者肠道准备质量的因素。按照候诊时间分组,倾向性匹配分析后,比较各组患者肠道准备质量差异。结果共有251例患者纳入研究。多因素分析显示,高血压(OR=3.530,95%CI 1.295~9.618)、慢性便秘(OR=3.302,95%CI 1.132~9.632)、饮食依从性(OR=0.161,95%CI 0.070~0.371)、服药及饮水量依从性(OR=0.167,95%CI 0.070~0.397)、服药后活动量依从性(OR=2.245,95%CI 1.040~4.845)、服药后排便次数(OR=0.446,95%CI 0.308~0.647)、候诊时间(OR=0.537,95%CI 0.387~0.745)是影响住院老年患者肠道准备质量的重要因素。不同候诊时间分组间的肠道准备质量存在差异,120~180 min组肠道准备整体质量显著优于241~300 min组、301~360 min组和>360 min组,181~240 min组肠道准备整体质量优于>360 min组(均P<0.05),其余各组之间比较差异无统计学意义(P>0.05)。分肠段比较,120~180 min组盲肠和升结肠评分最优,降结肠、乙状结肠和直肠的得分结果显示,仅181~240 min肠道准备质量优于301~360 min组及>360 min组。结论老年患者最佳检查时间在完成肠道准备后180 min左右,医护工作者应灵活指导用药时间,保证患者在检查时处于肠道最佳清洁状态。Objective To explore the influencing factors of bowel preparation quality in hospitalized elderly patients,and to find the appropriate waiting time from the end of bowel preparation to the beginning of colonoscopy.Methods Baseline and clinical data of elderly patients over 60 years old who underwent colonoscopy in the Tenth People′s Hospital,Tongji University from February 2021 to August 2021 were collected.Multivariate analysis was used to screen the factors that might affect the quality of bowel preparation in hospitalized elderly patients.Patients were grouped according to waiting time before colonoscopy.After eliminating confounding factors using propensity matching analysis,the difference of bowel preparation quality among groups was compared.Results 251 patients were included in the study.Multivariate analysis revealed that,hypertension(OR=3.530,95%CI 1.295-9.618),chronic constipation(OR=3.302,95%CI 1.132-9.632),dietary compliance(OR=0.161,95%CI 0.070-0.371),medication and drinking water compliance(OR=0.167,95%CI 0.070-0.397),exercise compliance after medication(OR=2.245,95%CI 1.040-4.845),The frequency of defecation after medication(OR=0.446,95%CI 0.308-0.647)and waiting time(OR=0.537,95%CI 0.387-0.745)were important factors affecting the quality of bowel preparation in hospitalized elderly patients(P<0.05).There were differences in bowel preparation quality between groups of waiting times.The overall quality of bowel preparation in 120-180 min group was significantly better than that in 241-300 min group,301-360 min group and>360 min group(P<0.05).The overall quality of bowel preparation in 181-240 min group was better than that in>360 min group(P<0.05).There were no significant differences among other groups(P>0.05).The scores of cecum and ascending colon were the best in 120-180 min group,and the cleanliness of descending colon,sigmoid colon and rectum was significantly higher in 241-300 min group,301-360 min group and>360 min group.The scores of descending colon,sigmoid colon and rectum showed that t

关 键 词：结肠镜检查 肠道准备 等待时间 倾向性匹配 

分 类 号：R473.5[医药卫生—护理学]