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[儿童结肠镜检查前聚乙二醇电解质散联合饮食控制肠道准备质量的影响因素]

[Influencing factors for the quality of bowel preparation with polyethylene glycol electrolyte powder combined with diet control before colonoscopy in children].

作者信息

Jiao Feng-Fei, Liu Zhi-Feng, Shen Yan-Chi, Cao Jin-Jin, Gao Yuan, Wang Hui, Tang Wei-Ting, Huang Yan

机构信息

Department of Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2022 Apr 15;24(4):366-371. doi: 10.7499/j.issn.1008-8830.2111019.

Abstract

OBJECTIVES

To investigate the influencing factors for the quality of bowel preparation before colonoscopy in children and the association of the interval from the last administration of laxative to the start of colonoscopy (shortly referred to as waiting time) with the quality of bowel preparation.

METHODS

A retrospective analysis was performed for the children who were admitted to the Department of Gastroenterology, Children's Hospital of Nanjing Medical University, from January to November 2020, and received bowel preparation with polyethylene glycol electrolyte powder combined with diet control before colonoscopy. According to the score of Boston bowel preparation scale, they were divided into two groups: adequate bowel preparation group (=337) and inadequate bowel preparation group (=30). Related data were collected from the children in both groups, including general information, possible influencing factors for the quality of bowel preparation, adverse reactions associated with bowel preparation, duration of colonoscopy, and postoperative diagnosis. Univariate and multivariate analyses were used to explore the influencing factors for the quality of bowel preparation.

RESULTS

The univariate analysis showed that age, body weight, and waiting time were associated with inadequate bowel preparation (<0.05). The multivariate analysis showed that older age (=2.155, 95%: 1.087-4.273, =0.028) and longer waiting time (=1.559, 95% : 1.191-2.041, =0.001) were independent risk factors for inadequate bowel preparation. The receiver operating characteristic (ROC) curve analysis showed that the cut-off value of waiting time was 5.5 hours in determining whether bowel preparation was adequate or not, with a sensitivity of 90.0%, a specificity of 50.7%, and an area under the ROC curve of 0.708. After grouping based on waiting time, it was found that the incidence rate of inadequate bowel preparation in the ≥5.5 hours group was significantly higher than that in the <5.5 hours group [14.0% (27/193) 1.7% (3/174), <0.001].

CONCLUSIONS

For children who use polyethylene glycol electrolyte powder combined with diet control for bowel preparation, older age is an independent risk factor for inadequate bowel preparation before colonoscopy, which may be associated with an insufficient dose of polyethylene glycol in older children. Longer waiting time is also an independent risk factor for inadequate bowel preparation, and it is recommended that the waiting time should not exceed 5.5 hours.

摘要

目的

探讨儿童结肠镜检查前肠道准备质量的影响因素,以及最后一次服用泻药至结肠镜检查开始的间隔时间(以下简称等待时间)与肠道准备质量的相关性。

方法

对2020年1月至11月在南京医科大学附属儿童医院消化内科住院、结肠镜检查前采用聚乙二醇电解质散联合饮食控制进行肠道准备的儿童进行回顾性分析。根据波士顿肠道准备量表评分,将其分为两组:肠道准备充分组(=337例)和肠道准备不充分组(=30例)。收集两组儿童的相关资料,包括一般信息、肠道准备质量的可能影响因素、肠道准备相关不良反应、结肠镜检查时长及术后诊断。采用单因素和多因素分析探讨肠道准备质量的影响因素。

结果

单因素分析显示,年龄、体重和等待时间与肠道准备不充分相关(<0.05)。多因素分析显示,年龄较大(=2.155,95%可信区间:1.087 - 4.273,=0.028)和等待时间较长(=1.559,95%可信区间:1.191 - 2.041,=0.001)是肠道准备不充分的独立危险因素。受试者工作特征(ROC)曲线分析显示,等待时间的截断值为5.5小时,用于判断肠道准备是否充分,灵敏度为90.0%,特异度为50.7%,ROC曲线下面积为0.708。根据等待时间分组后发现,≥5.5小时组肠道准备不充分的发生率显著高于<5.5小时组[14.0%(27/193)对1.7%(3/174),<0.001]。

结论

对于采用聚乙二醇电解质散联合饮食控制进行肠道准备的儿童,年龄较大是结肠镜检查前肠道准备不充分的独立危险因素,这可能与大龄儿童聚乙二醇剂量不足有关。等待时间较长也是肠道准备不充分的独立危险因素,建议等待时间不应超过5.5小时。

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