结肠镜检查过程中报告节段性肠道准备评分在临床实践中的重要性。
Importance of reporting segmental bowel preparation scores during colonoscopy in clinical practice.
作者信息
Jain Deepanshu, Momeni Mojdeh, Krishnaiah Mahesh, Anand Sury, Singhal Shashideep
机构信息
Deepanshu Jain, Internal Medicine Department, Albert Einstein Medical Centre, PH 19141, United States.
出版信息
World J Gastroenterol. 2015 Apr 7;21(13):3994-9. doi: 10.3748/wjg.v21.i13.3994.
AIM
To evaluate the impact of reporting bowel preparation using Boston Bowel Preparation Scale (BBPS) in clinical practice.
METHODS
The study was a prospective observational cohort study which enrolled subjects reporting for screening colonoscopy. All subjects received a gallon of polyethylene glycol as bowel preparation regimen. After colonoscopy the endoscopists determined quality of bowel preparation using BBPS. Segmental scores were combined to calculate composite BBPS. Site and size of the polyps detected was recorded. Pathology reports were reviewed to determine advanced adenoma detection rates (AADR). Segmental AADR's were calculated and categorized based on the segmental BBPS to determine the differential impact of bowel prep on AADR.
RESULTS
Three hundred and sixty subjects were enrolled in the study with a mean age of 59.2 years, 36.3% males and 63.8% females. Four subjects with incomplete colonoscopy due BBPS of 0 in any segment were excluded. Based on composite BBPS subjects were divided into 3 groups; Group-0 (poor bowel prep, BBPS 0-3) n = 26 (7.3%), Group-1 (Suboptimal bowel prep, BBPS 4-6) n = 121 (34%) and Group-2 (Adequate bowel prep, BBPS 7-9) n = 209 (58.7%). AADR showed a linear trend through Group-1 to 3; with an AADR of 3.8%, 14.8% and 16.7% respectively. Also seen was a linear increasing trend in segmental AADR with improvement in segmental BBPS. There was statistical significant difference between AADR among Group 0 and 2 (3.8% vs 16.7%, P < 0.05), Group 1 and 2 (14.8% vs 16.7%, P < 0.05) and Group 0 and 1 (3.8% vs 14.8%, P < 0.05). χ(2) method was used to compute P value for determining statistical significance.
CONCLUSION
Segmental AADRs correlate with segmental BBPS. It is thus valuable to report segmental BBPS in colonoscopy reports in clinical practice.
目的
评估在临床实践中使用波士顿肠道准备量表（BBPS）报告肠道准备情况的影响。
方法
本研究为前瞻性观察队列研究，纳入接受结肠镜筛查的受试者。所有受试者均接受1加仑聚乙二醇作为肠道准备方案。结肠镜检查后，内镜医师使用BBPS确定肠道准备质量。将各节段评分合并以计算综合BBPS。记录检测到的息肉部位和大小。审查病理报告以确定高级别腺瘤检出率（AADR）。计算节段性AADR，并根据节段性BBPS进行分类，以确定肠道准备对AADR的不同影响。
结果
本研究共纳入360名受试者，平均年龄59.2岁，男性占36.3%，女性占63.8%。4名因任何节段BBPS为0导致结肠镜检查不完全的受试者被排除。根据综合BBPS，受试者分为3组；0组（肠道准备差，BBPS 0 - 3）n = 26（7.3%），1组（肠道准备欠佳，BBPS 4 - 6）n = 121（34%），2组（肠道准备充分，BBPS 7 - 9）n = 209（58.7%）。AADR从1组到3组呈线性趋势；分别为3.8%、14.8%和16.7%。节段性AADR也随着节段性BBPS的改善呈线性增加趋势。0组和2组之间AADR有统计学显著差异（3.8%对16.7%，P < 0.05），1组和2组之间（14.8%对16.7%，P < 0.05），0组和1组之间（3.8%对14.8%，P < 0.05）。采用χ(2)法计算P值以确定统计学显著性。
结论
节段性AADR与节段性BBPS相关。因此，在临床实践的结肠镜检查报告中报告节段性BBPS是有价值的。
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