Van Dongen Monica
Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Gastroenterol Nurs. 2012 Jan-Feb;35(1):36-44. doi: 10.1097/SGA.0b013e3182403413.
Colorectal cancer is the third most common cancer and second leading cause of cancer-related deaths in the United States. Currently, colonoscopy is considered the gold standard to detect colorectal cancer. Poor bowel preparation in patients undergoing colonoscopy compromises the quality and efficacy of this procedure, affecting patient outcomes and increasing overall costs. With up to 25% of patients undergoing colonoscopy having poor bowel preparation, interventions to enhance the quality of bowel preparations are vital to improving clinical practice. Through an extensive review of the current literature, split-dose bowel preparation regimens appear to be the most well-supported and plausible intervention for meaningful change in efforts to enhance bowel preparation. Several studies of high quality and strength have drawn consistent conclusions that split-dose bowel preparations result in significantly better bowel cleansing than traditional day-prior bowel preparation regimens. Strengths, limitations, gaps in the current literature, and areas for future research are identified, which can help to direct future studies needed to strengthen the evidence and determine further practice initiatives to address the problem of poor bowel preparation for colonoscopy.
结直肠癌是美国第三大常见癌症，也是癌症相关死亡的第二大主要原因。目前，结肠镜检查被认为是检测结直肠癌的金标准。接受结肠镜检查的患者肠道准备不佳会损害该检查的质量和效果，影响患者预后并增加总体成本。高达25%接受结肠镜检查的患者肠道准备不佳，因此采取干预措施提高肠道准备质量对于改善临床实践至关重要。通过对当前文献的广泛回顾，分次给药肠道准备方案似乎是在提高肠道准备效果方面最有依据且合理的干预措施。多项高质量、高强度的研究得出了一致结论，即分次给药肠道准备比传统的提前一天肠道准备方案能显著更好地清洁肠道。文中还指出了当前文献的优势、局限性、空白以及未来研究方向，这有助于指导未来所需的研究，以加强证据并确定进一步的实践举措，从而解决结肠镜检查肠道准备不佳的问题。
