结肠镜检查分次肠道准备方案中用药时间间隔对肠道准备质量的影响初探
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1.海军军医大学第一附属医院全科;2.海军军医大学第一附属医院消化内科;3.海军军医大学第一附属医院肛肠外科;4.张家口市第五医院肛肠外科;5.海军军医大学第一附属医院消化内科,国家消化病临床医学研究中心;6.海军军医大学第一附属医院消化内科,国家消化病临床医学研究中心,海军军医大学第一附属医院消化内镜中心

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国家重点研发计划(2023YFC2413801);国家自然科学基金(82170567,82300627);博士后创新人才支持计划(BX20230482);上海市优秀学术/技术带头人计划(22XD1425000);上海市自然科学基金(23ZR1478700);上海市启明星培育计划扬帆专项(23YF1458600);上海市教委与上海市教育发展基金晨光计划(22CGA42);海军军医大学“深蓝”人才工程


A preliminary study of the effects of medication interval on the quality of split‑dose bowel preparation before colonoscopy
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National Key Research and Development Program of China (2023YFC2413801); National Natural Science Foundation of China (82170567, 82300627); National Postdoctoral Program for Innovative Talents (BX20230482); Shanghai Excellent Academic/Technology Leader Program(22XD1425000); Natural Science Foundation of Shanghai (23ZR1478700); Shanghai Star Cultivation Sailing Special Program (23YF1458600); Chenguang Program of Shanghai Municipal Education Commission and Shanghai Education Development Foundation (22CGA42); Deep Blue Talents Project of Naval Medical University

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    摘要:

    目的 探索分次肠道准备方案中用药时间间隔对肠道准备质量的影响并分析影响肠道准备质量的危险因素。方法 本项初探性研究为双中心研究,研究对象为2023年4~6月间于海军军医大学第一附属医院(n=46)和张家口市第五医院(n=20)行筛查、监测和诊断性结肠镜检查的成年门诊患者。按指南标准进行肠道准备,根据聚乙二醇两次服药的间隔时间,将研究对象分为短间隔(4~<10 h)组(n=45)和长间隔(10~16 h)组(n=21)。比较两组患者主观评价指标(患者肠道准备方案愿意重复率、肠道准备满意度、睡眠质量满意度等)、排便次数、波士顿肠道准备评分、肠道准备气泡评分、肠道准备合格率、息肉检出率、不良反应发生率的差异。采用单因素logistic回归分析影响肠道准备质量的相关因素。结果 短间隔组和长间隔组肠道准备方案愿意重复率[88.9%(40/45)比85.7%(18/21),χ2<0.001,P>0.999]、肠道准备满意度[65.9%(29/45)比57.1%(12/21),χ2=0.469,P=0.493]、睡眠质量满意度[35.6%(16/45)比28.6%(6/21),χ2=0.314,P=0.575]等患者主观评价指标差异无统计学意义。短间隔组和长间隔组排便次数[(11.3±4.8)次比(10.2±4.4)次,t=0.861,P=0.395]、波士顿肠道准备评分[(8.2±1.4)分比(7.9±1.2)分,t=1.024,P=0.311]、肠道准备气泡评分[(8.6±1.0)分比(8.4±1.5)分,t=0.672,P=0.506]、肠道准备合格率[88.9%(40/45)比90.5%(19/21),χ2<0.001,P>0.999]、息肉检出率[33.3%(15/45)比47.6%(10/21),χ2=1.242,P=0.265]和不良反应发生率[24.4%(11/45)比14.3%(3/21),χ2=0.381,P=0.537]等差异均无统计学意义。单因素logistic回归分析提示低纤维素饮食(OR=8.100,95%CI:1.400~46.849,P=0.019)是肠道准备合格的影响因素。结论 结肠镜检查分次肠道准备方案中,两剂聚乙二醇之间的用药间隔对肠道准备是否合格无显著影响。术前的低纤维素饮食是肠道准备合格的保护因素。

    Abstract:

    Objective To explore the effects of medication interval on the quality of split-dose bowel preparation and analyze the independent risk factors affecting the quality of bowel preparation. Methods This pilot study involved two centers. Adult outpatients who underwent screening, surveillance, and diagnostic colonoscopy in the First Affiliated Hospital of Naval Medical University (n=46) and the Fifth Hospital of Zhangjiakou (n=20) between April and June 2023 were enrolled. Bowel preparation was conducted based on the guideline. Patients were divided into the short-interval group (4-<10 hours, n=45) and the long-interval group (10-16 hours, n=21) based on the time between the two administrations of polyethylene glycol during bowel preparation. Differences in terms of patient-reported outcome measurements (patient-reported willingness to repeat the bowel preparation regimen, satisfaction with bowel preparation, satisfaction with sleep), defecation frequency, Boston bowel preparation scale scores, bowel preparation bubble scores, bowel preparation qualified rates, polyp detection rates and incidence of adverse events were compared. Relevant factors influencing bowel preparation quality were analyzed by univariate logistic regression. Results There were no significant differences in patient-reported willingness to repeat the bowel preparation regimen [88.9% (40/45) VS 85.7% (18/21), χ²<0.001, P>0.999], the satisfaction with bowel preparation [65.9% (29/45) VS 57.1% (12/21), χ²=0.469, P=0.493], or the satisfaction with sleep quality [35.6% (16/45) VS 28.6% (6/21), χ²=0.314, P=0.575] between the short-interval and long-interval groups. Similarly, no significant differences were observed between the groups in defecation frequency (11.3±4.8 VS 10.2±4.4, t=0.861, P=0.395), Boston bowel preparation scale scores (8.2±1.4 scores VS 7.9±1.2 scores, t=1.024, P=0.311), bowel preparation bubble scores (8.6±1.0 scores VS 8.4±1.5 scores, t=0.672,P=0.506), bowel preparation qualified rates [88.9% (40/45) VS 90.5% (19/21), χ²<0.001, P>0.999], polyp detection rates [33.3% (15/45) VS 47.6% (10/21), χ²=1.242, P=0.265], or incidence of adverse events [24.4% (11/45) VS 14.3% (3/21), χ²=0.381, P=0.537]. Univariate logistic analysis suggested that a low-fiber diet (OR=8.100, 95%CI:1.400-46.849, P=0.019) was an influencing factor for qualified bowel preparation. Conclusion Medication interval of the two doses of polyethylene glycol in a split-dose bowel preparation regimen for colonoscopy has no significant impact on bowel preparation quality. Notably, preoperative low-fiber diet emerges as an independent protective factor for qualified bowel preparation.

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徐庶怀,隋向宇,万苗,等.结肠镜检查分次肠道准备方案中用药时间间隔对肠道准备质量的影响初探[J].中华消化内镜杂志,2025,42(4):288-293.

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  • 收稿日期:2023-10-28
  • 最后修改日期:2025-04-09
  • 录用日期:2023-11-20
  • 在线发布日期: 2025-04-11
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