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脊髓损伤患者的结直肠癌筛查与普通人群在有效的肠道准备下结果相似:一项回顾性病历审核

Colorectal cancer screening in patients with spinal cord injury yields similar results to the general population with an effective bowel preparation: a retrospective chart audit.

作者信息

Teng Brandon J, Song Shawn H, Svircev Jelena N, Dominitz Jason A, Burns Stephen P

机构信息

University of Washington, Seattle, WA, USA.

Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.

出版信息

Spinal Cord. 2018 Mar;56(3):226-231. doi: 10.1038/s41393-017-0025-3. Epub 2017 Nov 24.

Abstract

STUDY DESIGN

Retrospective chart audit.

OBJECTIVES

To compare adequacy of colonoscopy bowel preparation and diagnostic findings between persons with SCI receiving an extended inpatient bowel preparation and the general population.

SETTING

Veterans Affairs Puget Sound Healthcare System, Seattle, WA, USA.

METHODS

We reviewed an electronic database of all colonoscopies performed at a tertiary Veterans Affairs medical center between 7/12/13 and 15/10/15. Patients with SCI received a multi-day bowel preparation with magnesium citrate, and 8-10 liters of polyethylene glycol-3350 and electrolyte colonic lavage solution (PEG-ELS) over two and one half days. The control population received a standard bowel preparation consisting of magnesium citrate and 4 liters of PEG-ELS over 1 day.

RESULTS

Two hundred and fifty-five patients were included in the study, including 85 patients with SCI. Average risk screening was a more common colonoscopy indication in patients with SCI vs. the control population (24 vs. 13% p = 0.03). There was no difference in adequacy of bowel preparation (87 vs. 85%, p = 0.73) or adenoma detection rate (55 vs. 51%, p = 0.59) when comparing patients with SCI with the control population. No difference in polyp histopathology was detected (p = 0.748).

CONCLUSIONS

Our study demonstrated that an extended bowel preparation for patients with SCI produces similar bowel preparation results and diagnostic yield when compared to patients without SCI undergoing colonoscopy.

摘要

研究设计

回顾性病历审核。

目的

比较接受延长住院期肠道准备的脊髓损伤患者与普通人群之间结肠镜检查肠道准备的充分程度及诊断结果。

地点

美国华盛顿州西雅图市退伍军人事务普吉特海湾医疗系统。

方法

我们回顾了一个电子数据库,该数据库包含2013年7月12日至2015年10月15日期间在一家三级退伍军人事务医疗中心进行的所有结肠镜检查。脊髓损伤患者在两天半的时间里接受了为期多天的肠道准备,使用了柠檬酸镁以及8 - 10升聚乙二醇-3350和电解质结肠灌洗液(PEG-ELS)。对照组人群在1天内接受了由柠檬酸镁和4升PEG-ELS组成的标准肠道准备。

结果

255名患者纳入研究,其中85名脊髓损伤患者。与对照组人群相比,平均风险筛查在脊髓损伤患者中是更常见的结肠镜检查指征(24%对1,3%,p = .03)。比较脊髓损伤患者与对照组人群时,肠道准备的充分程度(87%对85%,p = .73)或腺瘤检出率(55%对51%,p = .59)没有差异。息肉组织病理学方面未检测到差异(p = .748)。

结论

我们的研究表明,与未患脊髓损伤而接受结肠镜检查的患者相比,为脊髓损伤患者进行延长的肠道准备可产生相似的肠道准备结果和诊断率。

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