| Objective This study aimed to investigate the effect of picture intervention on improving cleanliness of intestine and detection rate of polyps.Methods(1)Clear research object: According to the inclusion criteria and exclusion criteria,the data of patients undergoing colonoscopy in our hospital from February 2017 to February 2018 were collected and grouped according to completely random single blind design.Divided into two groups:picture intervention group,General communication control group.In the picture intervention group,the patient was informed of the general bowel preparation,and the full-time staff additionally showed the patient a picture of a jar containing different gradient turbidity manure.The four gradients are:1)Intestinal preparation is poor: contains a large amount of residue;2)Intestinal preparation is poor: a small amount of residue;3)Good intestinal preparation: no residue,the color of the fecal water is turbid.4)The bowel is ready: the color of the manure is clear.The state in which the patient has diarrhea to stool is "4" is considered as intestinal cleansing.(2)Collect patient basic information,such as: Age,gender,circumference of abdomen,weight,body mass index(BMI),previous history of colonoscopy.(3)When the patient is preparing for the bowel,the endoscopist records the amount of the PEG.(4)When the patient underwent colonoscopy,the same endoscopic surgeon operated and recorded the time of colonoscopy,the time of withdrawal,the amount of PEG,the score of the intestine,and the score of BBPS(boston bowel preparation scale).(5)Record adverse reactions when patients drink PEG;Record adverse reactions and scores of patients during colonoscopy;Record patient acceptance of colonoscopy.(6)For patients with polyps detected in the intestine,record the size and location of the polyps,and track the results of histopathological biopsy.(7)Data collection:Data analysis using SPSS 24.0 software.Results(1)A total of 753 eligible cases were included in the study.(2)The number of qualified cases of intestinal cleansing was 405 in the re-education group and 308 in the control group.The pass rate was 97.12% vs 91.67%(P=0.001).The difference was statistically significant.(3)Among the patients who were successfully enrolled,the BBPS score(6.48±0.701)in the re-education group was higher than that in the control group(6.06±0.665),and the difference was significant(P≤0.01).(4)There were significant differences in the amount of water(2703.14±509.54 vs 2591.82±514.59,p=0.003),caecal intubation time(5.53±2.22 vs 6.95±4.24,P<0.001),withdrawal time(6.14±0.03 vs6.98±0.29,P<0.001)between the two groups.(5)The score of intestinal bubble in the picture intervention group(0.92 ±0.899)was lower than that in the control group(1.12±0.850,P<0.002),in which the score of 0 and 2 had significant difference(P < 0.01).(6)Multivariate regression analysis showed that no picture intervention(OR 3.997,P < 0.001),water intake(OR 0.999,P < 0.004)and education(OR 0.675,P < 0.017)were inadequate for intestinal preparation.Factors affecting intestinal cavity cleanliness.(7)There were 159 cases of polyps in the picture intervention group and 84 cases of polyps in the control group(P < 0.001).The polyp detection rate was 38.13% vs 25.00%(P<0.001).The polyp detection rate was 38.13% vs 25.00%(P<0.001),which was related to the size of polyps.When the polyp size was 0-9mm,there was a significant difference between the two groups(P=0.028).As the diameter of polyps increased,there was no difference in the polyp detection rate between the two groups(P>0.05).(8)The detection rate of adenoma was 18.47% vs 11.61%(P < 0.001)and non-neoplastic polyp 19.66% vs 13.39%(P<0.022).There was significant difference between the two groups(P<0.05).(9)There were no significant differences between in the number of adverse effects of PEG between the two groups(96.64% vs 96.73%)in the picture intervention group and the control group(P=0.949).(10)During the completion of the colonoscopy,there was no difference in adverse reactions(abdominal distension and abdominal pain,nausea and vomiting,cold and sweat hunger)between the two groups(P=0.515).Conclusion(1)The picture intervention method can improve the cleanliness of the intestine,mainly to improve the cleaning of the transverse colon and the left colon.(2)The picture intervention method can improve the detection rate of intestinal polyps,mainly to improve the detection rate of small polyps(0-10 mm in diameter).(3)The picture intervention method can shorten the per-person examination time of patients and improve the working efficiency of endoscopists.(4)During the completion of the colonoscopy,the picture intervention method did not improve the patient’s adverse reactions(abdominal abdominal pain,nausea and vomiting,cold and hunger). |
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