预包装饮食与自备低渣食物对结肠镜检查肠道影响效果对比研究

发布时间：2018-01-11 23:32

  本文关键词：预包装饮食与自备低渣食物对结肠镜检查肠道影响效果对比研究　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 肠道准备 结肠镜检查 预包装饮食 低渣饮食 清洁度

【摘要】：目的:结肠镜检查目前已成为公认的诊断和治疗结肠疾病的金标准,是筛查结肠癌的重要手段,结肠镜检查的成败很大程度上取决于肠道准备的质量。理想的肠道准备应是能有效排空肠腔内容物,保证医生对镜下肠道粘膜的细致观察,且方便舒适,不引起严重不良反应。目前国内关于肠道准备的研究主要集中在肠道清洗剂种类、剂量、用药时机以及辅助用药等,关于饮食对肠道准备质量影响的研究特别少,为此,本研究通过对比预包装饮食与自备低渣食物对肠道准备质量的影响,探讨两组在肠道清洁度、排便变化、副反应、息肉检出率、患者满意度及医务人员满意度、糖尿病人空腹血糖变化等方面的不同,评估此方案的有效性、安全性、耐受性,为临床肠道准备提供理论依据。方法:本研究纳入155例于2016年1月-2016年6月在武警总医院院行结肠镜检查的门诊患者作为研究对象,随机分为预包装饮食组和自备低渣饮食组,采用单中心、单盲、前瞻性、对照研究。预包装饮食组(预包装组)检查前一天三餐摄入预包装食物,自备低渣饮食组(自备组)检查前一天按照常规摄入自备低渣饮食,两组清肠液均采用复方聚乙二醇电解质散3L,于检查当日晨4点口服。通过渥太华评分标准(Ottawa bowel preparation scale,OBPS)评价两组患者肠道清洁程度;通过调查问卷收集患者进食及服药期间副反应、饮食依从性、对预包装饮食满意度及对复方聚乙二醇电解质散(Sulfate-free Polyethylene Glycol Electrolyte Powder,SF-PEG)满意度,通过采集静脉血监测糖尿病患者空腹血糖变化以检测预包装饮食配方对糖尿病人适用性。采用SPSS 17.0软件进行统计分析,两组计量资料以均数±标准差((?)±S)表示,组间比较采用独立样本u或t’检验,非正态分布的计量资料和计数资料行x2检验,以P0.05为差异有统计学意义。结果:5例患者因未完成大肠镜检查而被剔除出实验,最终150例患者(预包装组75例,自备组75例)进入最后分析,肠镜均到达回盲部,两组患者的基本资料(性别、年龄、体重指数、便秘史、肠镜史、糖尿病史)比较,差异无统计学意义。1主要评估指标1)肠道清洁度:预包装组渥太华评分总分(3.13±1.41)分,低于自备低渣饮食组(5.11±0.91)分,预包装组肠道清洁度高,差异有统计学意义(p0.05);其中,预包装组左侧结肠(0.75±0.55)分,自备组左侧结肠(1.24±0.45)(p0.05),两组比较有统计学意义;预包装组右侧结肠(0.45±0.31),清洁度优于自备组(1.85±0.59)(p0.05),两组比较有有统计学意义;预包装组横结肠(1.11±0.52),自备组横结肠(0.78±0.44)(p0.05)两组比较无统计学意义;液体量预包装组(0.82±0.69),自备组(1.24±0.67),两组比较无统计学意义(p0.05)。预包装组肠道准备合格率88.0%,自备组肠道准备合格率69.3%,两组差异有统计学意义(p0.05)。2)排便情况:包括首次排便时间,排便次数,预包装组第一次排便时间(46.25±28.23)分,明显少于自备组(65.34±34.54)分,两组差异有统计学意义(p0.05),预包装组排便次数(5.67±1.63)次,少于自备组(8.24±2.26),两组差异有统计学意义(p0.05),预包装组进镜时间(5.35±1.63)分,少于自备组(8.24±2.26)分,两组差异有统计学意义(p0.05)。3)息肉发现率:预包装组息肉发现率37.3%,自备组息肉发现率32.0%,两组比较无统计学意义(p0.05)。2次要评估指标1)饮食依从性及副反应:预包装组患者饮食依从性94.7%,自备组只有69.3%,两组差异有统计学意义(p0.05),预包装组患者86.7%愿意重复此次饮食方案,自备组60.0%愿意重复此次饮食方案,两组差异有统计学意义(p0.05);副作用方面,预包装组恶心15例,呕吐9例,腹痛6例,腹胀3例,头晕4例,乏力5例,自备组恶心18例,呕吐10例,腹痛8例,腹胀2例,头晕6例,乏力8例,两组差异无统计学意义(p0.05)。2)医务人员满意度:调查所有内镜医师、门诊医师和护士对预包装组饮食满意度均为100%,对自备组饮食满意度分别为45.5%(p0.05)、56.0%(P0.05)、33.6%(P0.05)。3)观察糖尿病患者结肠镜检查前血糖值变化,与平时空腹血糖对比,未出现明显波动,无低血糖反应。结论:1预包装饮食用于结肠镜检查饮食准备安全有效,肠道清洁度优于自备低渣饮食组。2预包装饮食用于结肠镜检查饮食准备可以缩短第一次排便时间、减少排便次数,缩短进镜时间,提高肠镜检查质量。3预包装饮食可以提高病人饮食准备依从性,同时提高病人和医务人员满意度。
[Abstract]:Objective: colonoscopy has become the gold standard for the diagnosis and treatment of colon disease recognized, is an important means of screening for colon cancer, the quality of the success of colonoscopy depends largely on bowel preparation. Ideal bowel preparation should be effective emptying of luminal contents, ensure doctors to carefully observe intestinal endoscopic the mucous membrane, and convenient and comfortable, does not cause serious adverse reactions. At present, the domestic research on intestinal preparation mainly concentrated in the intestinal cleaning agent types, dosage, medication time and auxiliary medicine, research on diet preparation quality effect on intestinal are very few, therefore, this study by comparing the pre packaged food and food - low residue influence on the quality of bowel preparation, to investigate the two groups in the intestinal cleanliness, defecation changes, adverse reactions, the detection rate of polyps, patients satisfaction and satisfaction of medical staff, patients with diabetes fasting blood glucose change Other aspects of the different, to assess the effectiveness of this scheme, the safety, tolerability, and provide a theoretical basis for clinical intestinal preparation. Methods: This study included 155 patients in January 2016 -2016 year in June in the armed police general hospital for outpatient colonoscopy patients as the research object, randomly divided into pre packaged diet group and self low residue diet group, single center, single blind, prospective, controlled study. Pre packaged diet group (pre packaging group) a day before meals intake check pre packaged food, low residue diet group (self owned group) the day before the inspection in accordance with the conventional intake - low residue diet, two groups were using Qingchang liquid polyethylene glycol electrolyte powder 3L, to check the same day at 4 a.m. by oral administration. Ottawa (Ottawa bowel preparation scale standard for evaluation, OBPS) evaluation of two groups of patients with intestinal cleanliness; through the questionnaire were collected and eating during medication side effects, drink Food compliance, satisfaction and diet on pre packaged of polyethylene glycol electrolyte powder (Sulfate-free Polyethylene Glycol Electrolyte Powder, SF-PEG) satisfaction, through changes in venous blood fasting blood sugar monitoring to detect pre packaged diet formula for diabetes applicability. Statistical analysis was performed using SPSS 17 software, two sets of measurement data to mean + the standard deviation ((?) + S) said that the groups were compared using independent samples u or T 'test, measurement data and count data for testing of the normal distribution of X2, P0.05 were statistically significant. Results: 5 patients did not complete due to the colonoscopy were excluded from the experiment, the final 150 cases patients (pre packaged group 75 cases, group owned 75 cases) in the final analysis, colonoscopy arrives at the ileocecal valve, the basic data of the two groups (gender, age, BMI, history of constipation, colonoscopy history, diabetes history comparison), 宸�寮傛棤缁熻�″�︽剰涔�.1涓昏�佽瘎浼版寚鏍�1)鑲犻亾娓呮磥搴，

本文编号：1411752