影响结肠镜前肠道清洁质量的相关因素探讨  

Discussion on Related Factors Affecting the Quality of Bowel Preparation Before Colonoscopy

作　　者：高英[1] 张彬彬[1] GAO Ying;ZHANG Binbin(Department of Outpatient,Digestive Hospital,Heilongjiang Provincial Hospital,Harbin Heilongjang 150001,China)

机构地区：[1]黑龙江省医院消化病院门诊,黑龙江哈尔滨150001

出　　处：《中国卫生标准管理》2023年第15期83-87,共5页China Health Standard Management

基　　金：黑龙江省卫健委科研课题(2019-164)。

摘　　要：目的筛选出优化肠道清洁度的因素,为肠镜检查提供良好的视野。方法选择2021年6—12月在黑龙江省医院消化病院内镜中心进行肠镜检查的患者195例作为研究对象,收集入选患者的性别、年龄、身高、体质量、有无腹部手术史、平素排便习惯、口服泻药的时间、口服泻药后排便次数、肠镜检查时段(上午或下午)、清肠结束至开始肠镜检查的间隔时间等信息。采用波士顿评分方法(Boston bowel preparation scale,BBPS)对肠道准备情况进行评分。对于收集的所有数据整理后,利用逐步回归分析、方差分析等统计学方法筛选出影响肠道准备质量的因素,并对筛选出的影响因素进行组内分析。结果以肠道BBPS分值作为肠道清洁程度的衡量标准及逐步回归中的因变量,以患者的性别、年龄、身高、体质量、有无腹部手术史、平素排便习惯、口服泻药的时间、口服泻药后排便次数、肠镜检查时段(上午或下午)、清肠结束至开始肠镜检查的间隔时间作为自变量,筛选出与BBPS评分相关的因素:口服泻药后排便次数、有无腹部手术史、肠镜检查时段、清肠后至开始肠镜检查的间隔时间4项,以标准化系数的大小为标准,4项因素对于BBPS评分影响程度分别为:口服泻药后排便次数(0.20)、肠镜检查时段(0.16)、腹部手术史(0.15)及清肠后至开始肠镜检查的间隔时间(0.14)。在肠道准备方式相同前提下,发现排便次数在7~10次时肠道清洁度较好;上午进行肠镜检查者BBPS评分低于下午进行肠镜检查者[(6.92±1.10)分vs.(7.41±0.62)分],差异有统计学意义(P<0.001);有腹部手术史者的患者其BBPS评分低于无腹部手术史者[(6.43±1.09)分vs.(7.08±1.01)分],差异有统计学意义(P=0.021);在口服泻药5 h后进行肠镜检查时肠道BBPS评分最高[(7.38±0.71)分],口服泻药3 h后进行肠镜检查时BBPS评分最低[(7.09±0.99)分],而口服泻药6 h以上进行�Objective To screen the useful factors of good preparation for colonoscopy in order to get clear vision.Methods A total of 195 patients who underwent colonoscopy in the Digestive Hospital,Heilongjiang Provincial Hospital from June to December 2021 were selected as the research object.Bowel preparation was assessed by Boston bowel preparation scale(BBPS).Stepwise regression analysis and analysis of variance were used to screen the factors with statistical significance on the bowel preparation quality.Results The BBPS score of intestinal tract was taken as the measure of intestinal cleanliness and the dependent variable in stepwise regression,and the patient's gender,age,height,weight,history of abdominal surgery,defecation habit,time of taking laxatives orally,defecation times after taking laxatives orally,colonoscopy period(morning or afternoon)and interval from the end of bowel cleaning to the beginning of colonoscopy were taken as independent variables.Four factors related to BBPS score were screened out:defecation times after taking laxatives orally,whether there was abdominal surgery history,colonoscopy examination period,and the interval between bowel cleaning and colonoscopy examination.Based on the standardized coefficient,the influence degrees of the four factors on BBPS score were:defecation times after taking laxatives orally(0.20),colonoscopy examination period(0.16),abdominal surgery history(0.15)and the interval from bowel cleaning to colonoscopy(0.14).On the premise of the same bowel preparation method,it was found that the cleanliness of the intestine was better when the number of defecation was 7-10 times.The BBPS score of those who underwent colonoscopy in the morning was lower than that of those who underwent colonoscopy in the afternoon[(6.92±1.10)points vs.(7.41±0.62)points],and the difference was statistically significant(P<0.001).The BBPS score of patients with a history of abdominal surgery was lower than that of patients without a history of abdominal surgery[(6.43±1.09)points vs.(7.08�

关 键 词：结肠镜 波士顿评分 肠道清洁程度 肠镜检查时段 肠镜检查间隔时间 排便次数 

分 类 号：R574[医药卫生—消化系统]