| 杨丽红,王玲,孙容容,屠冬英,杨雪芳.不同灌肠时机对慢性便秘患者结肠镜检查肠道准备效果的影响[J].上海护理,2023,23(9): |
| 不同灌肠时机对慢性便秘患者结肠镜检查肠道准备效果的影响 |
| Effect of different timing of enema on bowel preparation for colonoscopy in patients with chronic constipation |
| DOI： |
| 中文关键词: 结肠镜检查 慢性便秘 肠道准备 |
| 英文关键词:Colonoscopy Chronic constipation Bowel preparation |
| 基金项目:苏州市科教兴卫 |
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| 中文摘要: |
| 目的 探讨口服肠道清洁剂联合不同灌肠时机对慢性便秘患者结肠镜检查前肠道准备效果及安全性的影响。 方法 采用随机、单盲、前瞻性研究方法，将2020年10月～2022年9月于苏州市立医院东区消化科接受结肠镜检查的186例慢性便秘患者按照随机数字表法分成3组。对照组于检查日7：00服用2LPEG溶液，9：00服用1L0.9%生理盐水，10：00口服二甲硅油溶液30 ml；试验组I检查前1晚19:00实施清洁灌肠，后续同对照组；试验组II于检查当日清晨口服泻药后10:30予以清洁灌肠，后续同对照组。记录肠道准备合格率、排便总次数、各部分结肠的波士顿肠道准备评分及不良反应。 结果 试验组I和试验组II肠道准备合格率明显高于对照组（P=0.009，P=0.043）；试验组I排便总次数较试验组II和对照组多（P＜0.01）；试验组I右侧结肠评分明显高于试验组II和对照组（P=0.033，P＜0.01）；试验组I BBPS总分亦明显高于试验组II和对照组（P=0.023，P＜0.01）；3组间恶心、呕吐发生率比较，差异无统计学意义（P＞0.05），而在腹痛发生率方面，试验组I和试验组II较对照组低（P=0.027，P=0.008）；腹胀发生率方面，试验组I和试验组II较对照组低（P=0.032）。
结论 口服肠道清洁剂联合灌肠在肠道准备过程中可有效提高肠道准备合格率，降低腹痛、腹胀发生率。其中，口服泻药前灌肠组可显著增加慢性便秘患者排便总次数，提高右侧和全结肠清洁度。 |
| 英文摘要: |
| Objective? To investigate the effectiveness and safety of oral laxatives combined with different timing of enema on bowel preparation before colonoscopy for chronic constipation patients. Methods? A randomized, single-blind, prospective study was conducted on 186 patients with chronic constipation, who underwent colonoscopy in the digestivedepartment,Suzhou Municipal Hospital from October 2020 to September 2022. Patients were randomly divided into 3 groups. The control group took 2L PEG at 7:00 am, 1L0.9% normal saline at 9:00 am, and 30 ml of dimethicone at 10:00 am the day before colonoscopy. The group I underwent traditional enema at 19:00 pm the day before the colonoscopy, followed by the same control group; the group II was given cleaning enema at 10:30 am the day of colonoscopy after oral laxatives, followed by the same control group. The qualified rate of bowel preparation, total frequency of defecation, the score of Boston bowel preparation scale(BBPS)of each part of the colon and adverse reactions were recorded. Results? The qualified rate of bowel preparation in the group I and group II was significantly higher than that in control group (P = 0.009, P = 0.043). The total frequency of defecation in the group I was more than that in the group II and control group (P < 0.01).The BBPS score of the right colon in the group I was significantly higher than that of the group II and control group (P = 0.033, P < 0.01).The total BBPS score in the group I was also significantly higher than that of group II and control group (P = 0.023, P < 0.01). There was no statistical difference between the three groups in the incidence of nausea and vomiting? (P > 0.05), while in terms of the incidence of abdominal pain, the group I and group II were lower than those in control group (P = 0.027, P = 0.008).In addition, the same trend happened with bloating (P = 0.032).? Conclusion? Oral laxatives combined with enema can effectively improve the qualified rate of bowel preparation and reduce the incidence of abdominal pain and bloating during bowel preparation. Enema before oral laxative at the night before colonoscopy can significantly increase the total frequency of defecation and improve the cleanness of right and whole colon for chronic constipation patients. |
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