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
李潘1,2,李月月1,2,李延青1,2,3
LI Pan1,2, LI Yueyue1,2, LI Yanqing1,2,3
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。
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