基于电话的结肠镜检查前日再教育可提高肠道准备质量和息肉检出率：一项前瞻性、结肠镜医师盲法、随机、对照研究。

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.

机构信息

Xijing Hospital of Digestive Diseases, Fourth Military Medical University, , Xi'an, Shannxi, China.

出版信息

Gut. 2014 Jan;63(1):125-30. doi: 10.1136/gutjnl-2012-304292. Epub 2013 Mar 16.

DOI:10.1136/gutjnl-2012-304292

PMID:23503044

Abstract

BACKGROUND

Despite advances in bowel preparation methods, the quality of bowel preparation in some patients undergoing colonoscopy remains unsatisfactory. The effect of telephone re-education (TRE) on the day before colonoscopy on the quality of bowel preparation and other outcome measures had not been studied.

METHODS

A prospective colonoscopist-blinded study was conducted. All patients received regular instructions during a visit to discuss colonoscopy. Those scheduled for colonoscopy were randomly assigned to receive TRE on the day before colonoscopy (TRE group) for bowel preparation or no TRE (control group). The primary outcome was the rate of adequate bowel preparation. The secondary outcomes included polyp detection rate (PDR), non-compliance with instructions, and willingness to repeat bowel preparation.

RESULTS

A total of 605 patients were randomised, 305 to the TRE group and 300 to the control group. In an intention-to-treat analysis of the primary outcome, adequate preparation was found in 81.6% vs 70.3% of TRE and control patients, respectively (p=0.001). PDR was 38.0% vs 24.7% in the TRE and control group, respectively (p<0.001). Among patients with successful colonoscopy, the Ottawa scores were 3.0±2.3 in the TRE group and 4.9±3.2 in the control group (p<0.001). Fewer patients who showed non-compliance with instructions were found in the TRE group (9.4% vs 32.6%, p<0.001). No significant differences were observed between the two groups with regard to willingness to have a repeat bowel preparation (p=0.409).

CONCLUSIONS

TRE about the details of bowel preparation on the day before colonoscopy significantly improved the quality of bowel preparation and PDR.

摘要

背景

尽管肠道准备方法有所进步，但仍有部分患者在接受结肠镜检查时肠道准备质量不理想。结肠镜检查前一天的电话再教育（TRE）对肠道准备质量和其他结果指标的影响尚未得到研究。

方法

进行了一项前瞻性、盲法结肠镜检查者研究。所有患者在就诊时都接受了常规的结肠镜检查指导。接受结肠镜检查的患者被随机分为 TRE 组（TRE 组）或对照组（无 TRE 组），在结肠镜检查前一天接受 TRE 以准备肠道或不接受 TRE。主要结局是肠道准备充分的比例。次要结局包括息肉检出率（PDR）、不遵守指导意见和重复肠道准备的意愿。

结果

共纳入 605 例患者，305 例患者被分配至 TRE 组，300 例患者被分配至对照组。在意向治疗分析中，TRE 组和对照组肠道准备充分的比例分别为 81.6%和 70.3%（p=0.001）。TRE 组和对照组的 PDR 分别为 38.0%和 24.7%（p<0.001）。在成功完成结肠镜检查的患者中，TRE 组的 Ottawa 评分中位数为 3.0±2.3，对照组为 4.9±3.2（p<0.001）。TRE 组不遵守指导意见的患者比例较低（9.4% vs 32.6%，p<0.001）。两组患者对重复肠道准备的意愿无显著差异（p=0.409）。