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老年患者不同时间服用复方聚乙二醇电解质散肠道准备的效果

Effect observation of taking polyethylene glycol-electrolyte solution at different time on bowel preparation in elderly for colonscopy

摘要:

目的:比较老年患者分次剂量与单次全剂量服用复方聚乙二醇电解质溶液进行肠道准备的效果及不良反应,总结肠道准备的护理经验。方法将220例行结肠镜检查的老年患者根据计算机生成的随机数字表分为试验组和对照组,每组110例。试验组患者于结肠镜检查前1 d 17:00及检查当日6:00分次剂量服用复方聚乙二醇电解质散(PEG),每次1.5 L;对照组患者检查当日6:00单次全剂量服用PEG 3L清洁肠道。采用Boston肠道准备量表( BBPS)评估肠道清洁度,比较两组患者的不良反应及检查阳性率。结果试验组患者 BBPS 评分为(6.65±1.67)分,对照组患者 BBPS 评分为(6.14±1.91)分,两组比较差异有统计学意义(t=2.097,P<0.05)。试验组患者呕吐14例、腹痛34例、腹胀22例,均低于对照组(χ2值分别为4.400,4.111,4.002;P<0.05);试验组结肠息肉及结肠癌检出率为37.3%,高于对照组的24.5%(χ2=4.172,P<0.05)。结论采用结肠镜检查前当晚与检查当日分次剂量服用PEG可以改善肠道清洁效果,减少老年患者单次大量服用 PEG引起的不良反应,提高检查阳性率。

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Objective To compare the efficacy and side effects of split-dose Polyethylene glycol-electrolyte solution ( PEG ) with full-dose preparation in the elderly for colonoscopy, and to summary the experience of nursing care. Methods A total of 220 elderly undergoing colonoscopy were randomly divided into experimental group ( group A) and control group ( group B) , 110 cases in each group. Group A took half the dose of PEG (1. 5 L) at 5 PM on the day before colonoscopy and the remaining half (1. 5 L) were instructed to drink at 6 AM on the day of colonoscopy. Group B took all the PEG (3 L) at 6 AM on the day of colonoscopy. The quality of bowel cleansing was assessed according to the Boston bowel preparation scale ( BBPS) , and side effects ( nausea, vomiting, abdominal pain, fatigue and hunger ) and complication were also observed. In addition, the polyps and tumors of colon detection were compared within the two groups. Results The level of bowel preparation in group A was superior to group B [(6. 65 ± 1. 67) vs (6. 14 ± 1. 91, t =2. 097, P <0. 05)], however, the incidence of side effects such as nausea and vomiting, abdominal pain and bloating in group A were 14 cases, 34 cases and 22 cases less than those of group B (χ2 =4. 400,4. 111,4. 002,respectively;P<0. 05). The detection rate of colonic polyps and tumors in group A (37. 3%) were also higher than that of group B (24. 5%) (χ2 =4. 172, P<0. 05). Conclusions The use of a split-dose PEG for bowel preparation before colonoscopy significantly improved bowel preparation. Split-dose preparation is associated with a lower incidence of side effects, and higher detection rate of colonic polyps and tumors in the elderly.

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