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山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (3): 113-117.doi: 10.6040/j.issn.1671-7554.0.2019.1286

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个体化肠道准备对肠道准备质量的影响

李潘1,2,李月月1,2,李延青1,2,3   

  1. 山东大学齐鲁医院, 1.消化内科;2.胃肠疾病转化医学实验室; 3.胃肠道肿瘤机器人精准诊疗工程实验室, 山东 济南 250012
  • 出版日期:2020-03-10 发布日期:2022-09-27
  • 通讯作者: 李延青. E-mail:liyanqing@sdu.edu.cn
  • 基金资助:
    国家自然科学基金(81873550)

Effect of tailored bowel preparation on bowel preparation quality

LI Pan1,2, LI Yueyue1,2, LI Yanqing1,2,3   

  1. 1. Department of Gastroenterology;
    2. Laboratory of Translational Gastroenterology;
    3. Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Online:2020-03-10 Published:2022-09-27

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摘要： 目的 探究应用Dik VK等人建立的肠道准备失败预测模型(Dik VK 预测模型)指导个体化肠道准备是否可以提高肠道准备的质量。 方法 409例接受肠镜检查的患者随机分为个体化组和对照组,个体化组采用Dik VK预测模型对患者的肠道准备失败的风险进行分级并进行个体化肠道准备:高风险患者采取4 L 聚乙二醇电解质散(PEG)的方案进行肠道准备,低风险患者采用常规2 L PEG的方案。在对照组中,所有患者均服用2 L PEG。行结肠镜检查时记录患者肠道准备质量、息肉检出等结果。计量资料采用student-t检验进行分析,计数资料采用Pearson χ2检验进行分析。 结果 7例患者因为个人原因取消结肠镜预约,402例完成结肠镜并纳入ITT分析(个体化组n=202,对照组n=200)。个体化组的患者肠道准备成功率为89.6%,高于对照组的77.5%(P=0.002),差异具有统计学意义。个体化组波士顿肠道准备评分(BBPS)总分高于对照组(7.12±1.43 vs 6.64±1.71,P=0.002),各个结肠段分段的评分也高于对照组(P=0.004, P=0.030, P=0.022)。个体化组中平均每例患者检出的息肉数目高于对照组(0.74±1.23 vs 0.49±0.87,P=0.020),差异具有统计学意义。两组患者在不良反应发生率、满意度评分方面差异无统计学意义。 结论 应用Dik VK预测模型指导个体化肠道准备可以显著提高肠道准备的整体质量。

关键词: 肠道准备, 个体化肠道准备, 波士顿量表, 预测模型, 结肠镜

Abstract: Objective To investigate the effect of Dik VK predictive model in guiding bowel preparation. Methods A total of 409 patients who underwent colonoscopy were randomly assigned to tailored group and control group. Patients in the tailored group were assessed with Dik VK predictive model. Those with high risk of inadequate bowel preparation were prescribed a regimen of 4L polyethylene glycol(PEG), while those with low risk were given a normal dose of 2L PEG. Patients in the control group were prescribed a normal dose of 2L PEG. The bowel preparation quality and poly detection rate were recorded during colonoscopy. Continuous variables were analyzed using student-t test and categorical variables were analyzed using Pearson χ2 test. Results Seven patients cancelled colonoscopy appointment for personal reasons and finally 402 patients received colonoscopy and were included into ITT analysis(202 cases in tailored group, 200 cases in control group). The tailored group had higher adequate bowel preparation rate than the control group(89.6% vs 77.5%, P=0.002), higher total Boston Bowel Preparation Score(BBPS)(7.12±1.43 vs 6.64±1.71, P=0.002), higher scores for the separate three colon segments(P=0.004, P=0.030, P=0.022), and larger number of polyps detected per patient(0.74±1.23 vs 0.49±0.87, P=0.020). There were no differences in adverse reactions and degree of satisfaction between the two groups. Conclusion Tailored bowel preparation guided by the predictive model for inadequate bowel preparation significantly improves the overall quality of bowel preparation.

Key words: Bowel preparation, Tailored bowel preparation, Boston Bowel Preparation Score, Predictive model, Colonoscopy

中图分类号: 

  • R574
[1] Sung JJ, Ng SC, Chan FK, et al. An updated Asia Pacific Consensus Recommendations on colorectal cancer screening[J]. Gut, 2015, 64(1): 121-132.
[2] Rex DK, Imperiale TF, Latinovich DR, et al. Impact of bowel preparation on efficiency and cost of colonoscopy[J]. Am J Gastroenterol, 2002, 97(7): 1696-1700.
[3] Chokshi RV, Hovis CE, Hollander T, et al. Prevalence of missed adenomas in patients with inadequate bowel preparation on screening colonoscopy[J]. Gastrointest Endosc, 2012, 75(6): 1197-1203.
[4] Harewood GC, Sharma VK, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia[J]. Gastrointest Endosc, 2003, 58(1): 76-79.
[5] Liu X, Luo H, Zhang L, et al. Telephone-based re-education on the day before colonoscopy improves the quality of bowel preparation and the polyp detection rate: a prospective, colonoscopist-blinded, randomised, controlled study[J]. Gut, 2014, 63(1): 125-130.
[6] Froehlich F, Wietlisbach V, Gonvers JJ, et al. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study[J]. Gastrointest Endosc, 2005, 61(3): 378-384.
[7] Borg BB, Gupta NK, Zuckerman GR, et al. Impact of obesity on bowel preparation for colonoscopy[J]. Clin Gastroenterol Hepatol, 2009, 7(6): 670-675.
[8] Chan WK, Saravanan A, Manikam J, et al. Appointment waiting times and education level influence the quality of bowel preparation in adult patients undergoing colonoscopy[J]. BMC Gastroenterol, 2011, 11: 86. doi: 10.1186/1471-230X-11-86.
[9] Lebwohl B, Wang TC, Neugut AI. Socioeconomic and other predictors of colonoscopy preparation quality[J]. Dig Dis Sci, 2010, 55(7): 2014-2020.
[10] Diez-Rodriguez R, Rascarachi G, Khaliulina T, et al. Factors associated with colon cleansing measured with the Boston scale in routine clinical practice[J]. Gastroenterol Hepatol, 2015, 38(4): 274-279.
[11] Hassan C, Fuccio L, Bruno M, et al. A predictive model identifies patients most likely to have inadequate bowel preparation for colonoscopy[J]. Clin Gastroenterol Hepatol, 2012, 10(5): 501-506.
[12] Dik VK, Moons LM, Huyuk M, et al. Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation: development and validation of a prediction score[J]. Gastrointest Endosc, 2015, 81(3): 665-672.
[13] Gimeno-Garcia AZ, Baute JL, Hernandez G, et al. Risk factors for inadequate bowel preparation: a validated predictive score[J]. Endoscopy, 2017, 49(6): 536-543.
[14] Enestvedt BK, Tofani C, Laine LA, et al. 4-Liter split-dose polyethylene glycol is superior to other bowel preparations, based on systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2012, 10(11): 1225-1231.
[15] Martel M, Barkun AN, Menard C, et al. Split-dose preparations are superior to day-before bowel cleansing regimens: a meta-analysis[J]. Gastroenterology, 2015, 149(1): 79-88.
[16] Hookey LC, Vanner SJ. Pico-salax plus two-day bisacodyl is superior to pico-salax alone or oral sodium phosphate for colon cleansing before colonoscopy[J]. Am J Gastroenterol, 2009, 104(3): 703-709.
[17] 中国医师协会内镜医师分会消化内镜专业委员会, 中国抗癌协会肿瘤内镜学专业委员会. 中国消化内镜诊疗相关肠道准备指南(2019,上海)[J]. 中华消化内镜杂志, 2019, 36(7): 457-469.
[18] Lai EJ, Calderwood AH, Doros G, et al. The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research[J]. Gastrointest Endosc, 2009, 69(3 Pt 2): 620-625.
[19] Saltzman JR, Cash BD, Pasha SF, et al. Bowel preparation before colonoscopy[J]. Gastrointest Endosc, 2015, 81(4): 781-794.
[20] Kim HG, Jeon SR, Kim MY, et al. How to predict adequate bowel preparation before colonoscopy using conventional polyethylene glycol: prospective observational study based on survey[J]. Dig Endosc, 2015, 27(1): 87-94.
[21] Ness RM, Manam R, Hoen H, et al. Predictors of inadequate bowel preparation for colonoscopy[J]. Am J Gastroenterol, 2001, 96(6): 1797-1802.
[22] Chung YW, Han DS, Park KH, et al. Patient factors predictive of inadequate bowel preparation using polyethylene glycol: a prospective study in Korea[J]. J Clin Gastroenterol, 2009, 43(5): 448-452.
[23] Kazarian ES, Carreira FS, Toribara NW, et al. Colonoscopy completion in a large safety net health care system[J]. Clin Gastroenterol Hepatol, 2008, 6(4): 438-442.
[24] 邹杏坚, 何雪英, 陈晓华. 个体化肠道准备管理对患者结肠镜检查前肠道清洁度的影响[J]. 临床医学工程, 2018, 25(11): 1561-1562.
[25] 张彩霞. 个体化健康教育在结肠镜检查肠道准备中的应用[J]. 首都食品与医药, 2019, 26(10): 160-161.
[26] 陈凯琪, 吴小丽. 老年结肠镜检查患者个体化肠道准备的效果观察[J]. 内科, 2013, 8(3): 341-342.
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