Department of Pharmacology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Department of Pharmacy, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China.
Ann Palliat Med. 2020 May;9(3):671-680. doi: 10.21037/apm.2020.03.33. Epub 2020 Apr 13.
Unsatisfactory bowel preparation has been reported in 1/3 of colonoscopy cases, with lack of good bowel preparation knowledge being one of the major causes. Although still unclear, educational video is thought to be a good method of improving bowel preparation.
A systematic review of eight randomized controlled trials (RCTs) comparing the educational video to control group among 1,977 patients was conducted. PubMed, Embase, Clinical Trials.gov, Cochrane Library, and reference lists were searched for relevant reported studies from inception until June 2019. Outcomes of interest included adequate bowel preparation, Ottawa scores, polyp detection, withdraw time, pain scores, and the anxiety state of patients. Besides random events meta-analyses, we also performed a sensitivity analysis to examine whether the results of the meta-analysis were robust.
Compared with the conventional group, the educational video group had significantly higher incidence of adequate bowel preparation [overall risk ratio (RR) =1.20, 95% CI: 1.14, 1.25, P<0.001], lower total Ottawa scores [overall standard mean difference (SMD) =-0.66, 95% CI: -0.91, -0.42, P<0.001]. However, there was no statistical difference in polyp detection, and withdraw time between the educational video and conventional groups (P>0.05). In addition, there were no sufficient RCTs to compare the pain scores and anxiety state of patients between the two groups through meta-analysis.
Our findings have demonstrated that educational video can improve bowel preparation in patients undergoing colonoscopy.
据报道，1/3 的结肠镜检查病例中存在肠道准备不充分的情况，而缺乏良好的肠道准备知识是主要原因之一。虽然原因尚不清楚，但教育视频被认为是改善肠道准备的一种好方法。
系统检索了PubMed、Embase、ClinicalTrials.gov、Cochrane 图书馆和参考文献中截至 2019 年 6 月的 8 项随机对照试验（RCT），比较了 1977 例患者中教育视频与对照组的肠道准备情况。主要结局指标为肠道准备充分率、Ottawa 评分、息肉检出率、退镜时间、疼痛评分和患者焦虑状态。除随机效应模型分析外，还进行敏感性分析以评估 Meta 分析结果的稳健性。
与常规组相比，教育视频组肠道准备充分率显著提高[总 RR=1.20，95%CI：1.14，1.25，P<0.001]，Ottawa 总评分显著降低[总 SMD=-0.66，95%CI：-0.91，-0.42，P<0.001]。然而，两组间息肉检出率和退镜时间差异无统计学意义（P>0.05）。另外，由于缺乏足够的 RCT，无法进行 Meta 分析比较两组患者的疼痛评分和焦虑状态。
我们的研究结果表明，教育视频可改善结肠镜检查患者的肠道准备。
