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有结肠镜检查史的患者在采用分剂量肠道准备后不太可能实现高质量的肠道准备。

Patients with History of Colonoscopy Are Less Likely to Achieve High Quality Preparation After Implementing Split-Dose Bowel Preparation.

作者信息

Madhoun M F, Bitar H, Parava P, Bashir M H, Zia H

机构信息

Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma Veterans Affairs Medical Center, Oklahoma City, Oklahoma.

Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

出版信息

Acta Gastroenterol Belg. 2017 Apr-Jun;80(2):257-261.

PMID:29560691

Abstract

BACKGROUND

Anecdotally, we observed that patients who had previous colonoscopies were less likely to follow newly implemented split-dose bowel preparation (SDBP) instructions. We investigated whether the indication for colonoscopy is an independent factor for achieving high quality bowel preparation among patients asked to follow SDBP.

METHODS

We performed a retrospective study of data from 1478 patients who received outpatient colonoscopies in 2014 (the year of SDBP implementation) at our Veterans Affairs Medical Center. We collected information related to demographics and factors known to affect bowel preparations. Reasons for colonoscopy were dichotomized into surveillance (previous colonoscopy) vs. non-surveillance (positive occult blood test or screening). Bowel preparation quality was scored using the Boston Bowel Preparation Scale (BBPS), and was categorized as either excellent vs. not excellent (BBPS≥7 vs. BBPS<7), or adequate vs. inadequate (BBPS≥6 vs. BBPS<6).

RESULTS

Bowel preparation quality was excellent in 60% of colonoscopies and adequate in 84% of colonoscopies. Thirty-six percent (535) were surveillance colonoscopies. In multivariate logistic regression analysis, more patients in the non-surveillance group achieved excellent (OR 0.8 ; 95% CI [0.7-0.8], P <0.0001) and adequate (OR 0.8 ; 95% CI [0.7-0.9], P <0.006) bowel preparation than did patients in the surveillance group.

CONCLUSION

Patients with a prior colonoscopy might not follow the split-dose bowel preparation instructions. Educational interventions emphasizing the benefits of SDBP in this group of patients may help ensure compliance and prevent the habitual use of day-before preparations.

摘要

背景

据观察，曾接受过结肠镜检查的患者似乎不太可能遵循新实施的分剂量肠道准备（SDBP）指示。我们调查了结肠镜检查的适应证是否是接受SDBP的患者实现高质量肠道准备的独立因素。

方法

我们对2014年（SDBP实施年份）在我们退伍军人事务医疗中心接受门诊结肠镜检查的1478例患者的数据进行了回顾性研究。我们收集了与人口统计学和已知影响肠道准备的因素相关的信息。结肠镜检查的原因分为监测（既往结肠镜检查）与非监测（潜血试验阳性或筛查）。肠道准备质量采用波士顿肠道准备量表（BBPS）评分，并分为优秀（BBPS≥7）与非优秀（BBPS<7），或充分（BBPS≥6）与不充分（BBPS<6）。

结果

60%的结肠镜检查肠道准备质量优秀，84%的结肠镜检查肠道准备充分。36%（535例）为监测性结肠镜检查。在多因素逻辑回归分析中，非监测组中实现优秀（比值比[OR]0.8；95%置信区间[CI][0.7 - 0.8]，P<0.0001）和充分（OR 0.8；95% CI[0.7 - 0.9]，P<0.006）肠道准备的患者比监测组患者更多。