老年患者结肠镜诊疗相关肠道准备质量的影响因素分析

目的 探讨老年患者结肠镜诊疗相关肠道准备质量的影响因素,为针对性干预提供依据.方法 前瞻性纳入我院拟行结肠镜诊疗的老年(≥65岁)患者120例,采用聚乙二醇(PEG)电解质散3L分次方案进行肠道准备,采用Holden步行功能分级标准(FAC)评估患者行走能力,采用波士顿评分标准(BBPS)评估患者肠道准备质量,单因素和多因素Logistic回归分析影响老年患者结肠镜检查肠道准备质量的因素.结果 本组肠道准备质量BBPS评分为(6.57±0.72)分,肠道准备充分率为68.3％ (82/120).单因素分析发现,合并糖尿病(P =0.002)、脑卒中(P=0.005)、服用三环类抗抑郁药(P =0.029)、行走困难(P =0.001)是老年患者肠道准备质量差的影响因素(P=0.05).多因素分析发现,合并糖尿病(OR=2.54,95％ CI:1.08 ～ 3.16,P=0.015)、行走困难(OR=4.36,95％ CI:2.37 ～13.41,P=0.003)是老年患者肠道准备质量差的独立危险因素(P=0.05).结论 糖尿病、行走困难是老年患者结肠镜诊疗相关肠道准备质量差的独立危险因素,临床上应重点加强对此类人群的干预.

Influencing factors of quality of bowel preparation for colonoscopy in elderly patients

Objective To investigate the factors influencing the quality of bowel preparation for colonoscopy in elderly patients.Methods A series of 120 elderly patients (≥ 65 years old) undergoing colonoscopy were prospectively enrolled into this study from May to December 2016.All patients received a standard program of 3 L polyethylene glycol (PEG) for bowel preparation.The ability to ambulate was evaluated by Holden walking function rating scale (FAC).The quality of bowel preparation was assessed using Boston Bowel Preparation Scale (BBPS).Univariate and multivariate logistic regression analysis were performed to determine significant factors influencing bowel preparation quality in elderly patients with colonoscopy.Results In this group,the BBPS score of bowel preparation was 6.57 ±0.72,and the rate of adequate bowel preparation was 68.3％ (82/120).Univariate analysis showed that diabetes mellitus (P =0.002),stroke (P =0.005),tricyclic antidepressants (P =0.029),and difficulty walking (P ＜ 0.001) was influence factors of the poor quality of bowel preparation in the elderly patients (P =0.05).Multivariate analysis found that the combination of diabetes mellitus (OR =2.54,95％ CI:1.08-3.16,P =0.015),walking difficulty (OR =4.36,95％CI:2.37-13.41,P =0.003) were independent risk factors for the poor quality of bowel preparation in the elderly patients (P =0.05).Conclusion Diabetes and difficulty with ambulation are the independent risk factors for poor quality of bowel preparation in elderly patients undergoing colonoscopy.