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中华结直肠疾病电子杂志 ›› 2020, Vol. 09 ›› Issue (06) : 576 -580. doi: 10.3877/cma.j.issn.2095-3224.2020.06.007

所属专题: 文献

论著

日间病房结直肠息肉切除患者的肠道准备质量现状调查
顾君君1, 赵子夜2, 韩文军3, 吴琴1, 王苗1, 陈佳4, 杨婷4, 于恩达5,()   
  1. 1. 200433 上海长海医院麻醉学部日间病房
    2. 200433 上海长海医院肛肠外科
    3. 200433 上海长海医院麻醉学部
    4. 200433 上海长海医院消化内镜中心
    5. 200433 上海长海医院肛肠外科;200433 上海长海医院消化内镜中心
  • 出版日期:2020-12-25
  • 通信作者: 于恩达
  • 基金资助:
    国家重点研发计划(No. 2017YFC1308800); 国家自然科学基金面上项目(No. 81870455); 海军军医大学护理学高峰学科青年培育工程孵化类项目(No. 18QPFH12)

Prevalence survey of bowel preparation quality in patients receiving colorectal polypectomy in day ward

Junjun Gu1, Ziye Zhao2, Wenjun Han3, Qin Wu1, Miao Wang1, Jia Chen4, Ting Yang4, Enda Yu5,()   

  1. 1. Day Wards, Shanghai Changhai Hospital, Shanghai 200433, China
    2. Department of Colorectal Surgery, Shanghai Changhai Hospital, Shanghai 200433, China
    3. Department of Anesthesia, Shanghai Changhai Hospital, Shanghai 200433, China
    4. GI Endoscopy Center, Shanghai Changhai Hospital, Shanghai 200433, China
    5. Department of Colorectal Surgery, Shanghai Changhai Hospital, Shanghai 200433, China; GI Endoscopy Center, Shanghai Changhai Hospital, Shanghai 200433, China
  • Published:2020-12-25
  • Corresponding author: Enda Yu
  • About author:
    Corresponding author: Yu Enda, Email:
引用本文:

顾君君, 赵子夜, 韩文军, 吴琴, 王苗, 陈佳, 杨婷, 于恩达. 日间病房结直肠息肉切除患者的肠道准备质量现状调查[J/OL]. 中华结直肠疾病电子杂志, 2020, 09(06): 576-580.

Junjun Gu, Ziye Zhao, Wenjun Han, Qin Wu, Miao Wang, Jia Chen, Ting Yang, Enda Yu. Prevalence survey of bowel preparation quality in patients receiving colorectal polypectomy in day ward[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(06): 576-580.

目的

调查日间病房肠息肉切除患者的肠道准备现状及其与门诊、住院患者的差异。

方法

纳入2018年7月~2019年4月于上海长海医院日间病房、住院病房和门诊接受肠息肉切除患者4 278例,计算其肠道准备质量,分析肠道准备质量与患者性别、盲肠进镜情况、来源、时间档及工作档的关系。

结果

4 278例患者中14.7%的患者肠道准备不合格,男性显著差于女性(χ2=11.091,P<0.05);门诊患者的肠道准备质量显著优于日间病房和住院病房(χ2=16.610,P<0.05);上午、下午患者的肠道准备质量显著优于晚间患者(χ2=14.508,P<0.05)。日间病房患者在晚间及加班时间接受治疗的比例明显高于门诊和住院。

结论

日间病房肠息肉切除患者的肠道准备现状不佳,主要与非常规时间接受检查导致肠道准备与检查的间隔时间过长有关。综合应用多种手段来改善现状,尤其是有效控制肠道准备与接受检查的间隔时间将对提升日间病房患者的肠道准备质量具有现实意义。

Objective

To investigate the status of bowel preparation in patients receiving colorectal polypectomy in the day ward.

Methods

A total of 4 278 patients who had undergone bowel polypectomy in the day wards, inpatient wards, and outpatient clinic of Shanghai Changhai Hospital during July 2018 and April 2019 were included. The quality of bowel preparation was calculated. The relationship between the quality of bowel preparation and the patient's gender, cecal intubation, source, time period and work shift was analyzed.

Results

Among the 4 278 patients, 14.7% of the patients had unqualified bowel preparations, and that of men were significantly worse than that of women (χ2=11.091, P<0.05). The quality of bowel preparation of the outpatients was significantly better than that of the day wards and inpatient wards (χ2=16.610, P<0.05). The quality of bowel preparation in the morning and afternoon was significantly better than that in the evening (χ2=14.508, P<0.05). The proportion of patients in the day ward receiving colonoscopy in the evening and overtime is higher than that of outpatient and inpatient obviously.

Conclusions

Generally, the bowel preparation of patients receiving colorectal polypectomy in the day ward is not good. The main problem is the uncertainty of the patient's procedure time, which prolongs the interval between bowel preparation and procedure of most patients to exceed the recommended interval. Medical administrators should consider applying various methods to improve the quality of bowel preparation of ambulatory patients.

图1 研究样本筛选纳入流程
表1 肠道准备质量相关因素(总体)(±s,例)
表2 肠道准备质量相关因素(不同来源)(±s,例)
[1]
国际日间手术学会. 日间手术手册[M]. 北京: 人民卫生出版社, 2015.
[2]
蒋丽莎,马洪升. 日间手术评价与监控指标初探[J]. 华西医学, 2019, 34(2): 202-205.
[3]
张继东,闻大翔,骆华杰, 等. 日间医疗的实践探索与思考[J]. 中华医院管理杂志, 2017, 33(5): 345-348.
[4]
袁华娣,张秀来,马戈, 等. 基于患者安全的日间手术管理体系构建[J]. 中华医院管理杂志, 2017, 33(5): 352-354.
[5]
中华医学会消化内镜学分会. 中国消化内镜诊疗相关肠道准备共识意见[J]. 中华消化内镜杂志, 2013, 30(10): 541-549.
[6]
Gu P, Lew D, Oh SJ, et al. Comparing the real-world effectiveness of competing colonoscopy preparations: Results of a prospective trial[J]. Am J Gastroenterol, 2019, 114(2): 305-314.
[7]
Spadaccini M, Frazzoni L, Vanella G, et al. Efficacy and tolerability of high- vs low-volume split-dose bowel cleansing regimens for colonoscopy: a systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol 2020, 18(7): 1454-1465, e1414.
[8]
Aronchick CA, Lipshutz WH, Wright SH, et al. Validation of an instrument to assess colon cleansing [abstract][J]. Am J Gastroenterol, 1999, 94: 2667.
[9]
赵子夜,李骏强,单永琪, 等. 结直肠癌平均风险人群结肠镜检查息肉发现率与腺瘤发现率及其年龄分布情况[J]. 中华消化内镜杂志, 2014, 31(2): 64-68.
[10]
Allen JI. The Value of Colonoscopy [J]. Gastroenterology, 2014, 146: 573-375.
[11]
Wang CL, Huang ZP, Chen K, et al. Adenoma miss rate determined by very shortly repeated colonoscopy: Retrospective analysis of data from a single tertiary medical center in China [J]. Medicine (Baltimore), 2018, 97(38): e12297.
[12]
Zhao S, Wang S, Pan P, et al. Magnitude, risk factors, and factors associated with adenoma miss rate of tandem colonoscopy: a systematic review and meta-analysis [J]. Gastroenterology, 2019, 156(6): 1661-1674, e11.
[13]
Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy[J]. Gastrointest Endosc, 2015, 81(1): 31-53.
[14]
Chan WK, Saravanan A, Manikam J, et al. Appointment waiting times and education level influence the quality of bowel preparation in adult patients undergoing colonoscopy [J]. BMC Gastroenterol, 2011, 11: 86.
[15]
胡祥鹏,谢菁. 聚乙二醇电解质散肠道准备无效因素分析[J]. 中国内镜杂志, 2015, 21(8): 861-863.
[16]
Johnson DA, Barkun AN, Cohen LB, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer [J]. Gastroenterology, 2014, 147(4): 903-924.
[17]
刘俐,杨梅,张另. 内镜下治疗结肠息肉在日间病房与住院病房中的回顾性病例对照研究[J]. 第三军医大学学报, 2017, 39(18): 1832-1835.
[18]
Kim TK, Kim HW, Kim SJ, et al. Importance of the time interval between bowel preparation and colonoscopy in determining the quality of bowel preparation for full-dose polyethylene glycol preparation [J]. Gut Liver, 2014, 8(6): 625-631.
[19]
Seo EH, Kim TO, Park MJ, et al. Optimal preparation-to-colonoscopy interval in split-dose PEG bowel preparation determines satisfactory bowel preparation quality: an observational prospective study [J]. Gastrointest Endosc, 2012, 75(3): 583-590.
[20]
蔡贤黎,沈月红,李全林, 等. 消化内镜日间手术病房行结肠镜肠道准备的可行性研究[J]. 中华消化内镜杂志, 2019, 36(5): 334-338.
[21]
Marcondes FO, Gourevitch RA, Schoen RE, et al. Adenoma detection rate falls at the end of the day in a large multi-site sample [J]. Dig Dis Sci, 2018, 63(4): 856-859.
[22]
Long MD, Martin C, Sandler RS, et al. Reduced polyp detection as endoscopy shift progresses: experience with screening colonoscopy at a tertiary-care hospital [J]. J Clin Gastroenterol, 2011, 45(3): 253-258.
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