Zhang Lun, Lv Xiaoling, Zhu Qin, Zhou Jianying, Huang Hanlei, Huang Yiqian, Si Caijuan
Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China.
Zhejiang Key Laboratory of Geriatrics and Geriatrics Institute of Zhejiang Province, Zhejiang Hospital, Hangzhou, Zhejiang, China.
BMC Gastroenterol. 2025 Jul 1;25(1):457. doi: 10.1186/s12876-025-04059-8.
The concept of pre-rehabilitation has been clinically implemented across various surgical fields; however, studies investigating its application in colonoscopy remain limited. This study aimed to evaluate the effectiveness, safety, and patient satisfaction of the pre-rehabilitation concept in bowel preparation for comfort colonoscopy among elderly Chinese patients.
The enrolled patients were randomly allocated into the pre-rehabilitation and control groups. Prior to colonoscopy, patients in the pre-rehabilitation group received supplementary oral administration of ENSURE (Enteral Nutritional Powder) and psychological counseling provided by specialty nurses. The control group received only Polyethylene Glycol Electrolytes Powder. The primary outcome was the quality of bowel preparation, assessed using the Boston Bowel Preparation Scale. Secondary outcomes included the polyp detection rate, incidence of adverse effects, and patient satisfaction.
A total of 485 patients who were admitted for colonoscopy during hospitalization were included in the analysis. There were no statistically significant differences between the two groups with respect to age, sex, and body mass index (BMI). The Boston total score in the pre-rehabilitation group was significantly higher than that in the control group (P < 0.001). The colon polyp detection rates in the two groups were 78.5% and 67.3%, respectively (P = 0.006). Patients in the pre-rehabilitation group reported higher satisfaction with colonoscopy procedures and experienced a lower incidence of hypoglycemic reactions.
The combination of additional enteral nutrition supplements and psychological counseling can enhance the quality of bowel preparation, decrease the incidence of hypoglycemia, and improve patient satisfaction. This intervention measure is both feasible and worthy of clinical application and promotion.
This study was registered in the Chinese Clinical Trial Registry on 14/05/2025 (clinical trial registration number: ChiCTR2500102405). Retrospectively registered.
术前康复的概念已在多个外科领域临床应用；然而，关于其在结肠镜检查中的应用研究仍然有限。本研究旨在评估术前康复概念在老年中国患者舒适结肠镜检查肠道准备中的有效性、安全性和患者满意度。
将入选患者随机分为术前康复组和对照组。结肠镜检查前，术前康复组患者接受补充口服安素（肠内营养粉剂）及专科护士提供的心理咨询。对照组仅接受聚乙二醇电解质散。主要结局是肠道准备质量，采用波士顿肠道准备量表进行评估。次要结局包括息肉检出率、不良反应发生率和患者满意度。
共纳入485例住院期间接受结肠镜检查的患者进行分析。两组在年龄、性别和体重指数（BMI）方面无统计学显著差异。术前康复组的波士顿总分显著高于对照组（P < 0.001）。两组的结肠息肉检出率分别为78.5%和67.3%（P = 0.006）。术前康复组患者对结肠镜检查程序的满意度更高，低血糖反应发生率更低。
额外的肠内营养补充剂与心理咨询相结合可提高肠道准备质量，降低低血糖发生率，并提高患者满意度。这种干预措施既可行又值得临床应用和推广。
本研究于2025年5月14日在中国临床试验注册中心注册（临床试验注册号：ChiCTR2500102405）。回顾性注册。
