Study On The Factors Affecting The Quality Of Bowel Preparation For Colonoscopy

Objective: 1.To investigate the factors influencing the quality of bowel preparation for the quality of colonoscopy;2.Objective to investigate the clinical significance of individualized interventional bowel preparation in improving the quality of colonoscopy.Methods: 1.Collect information related quality of bowel preparation from patients of Outpatient or inpatient from Changsha city first hospital using polyethylene glycol electrolyte powder,sodium phosphate oral or 20% mannitol injection for bowel preparation from June to December 2016,using the chi square test and Logistic regression analysis to explore the factors(intestinal cleaning agents,age,gender,body mass index,whether the high fiber diet,abdominal and pelvic surgery,constipation,colonoscopy,history of cerebrovascular accident,do not need hospitalization,bowel preparation of History)and the relationship between the quality of bowel preparation.According to the selected intestinal cleanser,B1,B2 and B3 groups were used as the control group.During the period of June to December 2016,100 cases of inpatients with intestinal preparation were randomly selected with sodium phosphate oral solution,20% Mannitol Injection and polyethylene glycol electrolyte powder,and divided into A1,A2 and A3 groups.The observation group was set up.On the basis of routine bowel preparation education,age by medical personnel according to the patient’s gender,underlying disease,the dynamic observation and individualized intervention in the bowel preparation process,to check before the acidosis and electrolyte disorder in patients with appropriate treatment.Patients in the B group(control group)were prepared for bowel preparation by routine oral and written bowel preparation prior to routine endoscopic examination.2.All patients were examined before the examination of arterial blood gas analysis,electrolyte four,according to the intestinal cleaning agent group,statistics each group acid-base imbalance,electrolyte disorder incidence.3.Statistics of each group respectively(A1,A2,A3,B1,B2,B3)patients on the incidence of tolerance and complications of intestinal tract,intestinal cleaning effect(BBPS scale),arrived at the ileocecal valve,the success rate of colorectal polyp detection and whether patients are willing to accept colonoscopy again,In patients who cannot tolerate bowel preparation,willing to undergo colonoscopy rate,intestinal cleaning quality,ileocecal valve arrival rate,insertion time,total colorectal polyp detection rate as evaluation indexes,to discuss the individual intervention process to improve the significance of bowel preparation colonoscopy quality.Results: 1.The single factor analysis:There is no significant difference with intestinal cleaning drugs,age,gender,body mass index,whether the high fiber diet,abdominal pelvic surgery history,colonoscopy in history between the two groups of patients which the quality of bowel preparation is good and bad.There were significant differences withthe state of elderly,constipation,history of cerebrovascular accident,failure to require the completion of bowel preparation between two groups.2.The acid-base imbalance of patients with three kinds of intestinal cleaning agents,electrolyte disorder incidence rate,incidence rate of 20.59% sodium phosphate group and mannitol group was 18.57%,was higher than that of polyethylene glycol group 11.51%,there were significant differences in sodium phosphate group and mannitol group,between acid-base imbalance and electrolyte disorder incidence was not statistically significant.3.Individual intervention control study:(1)There was significant difference between the observation time and the ileocecal valve arrival rate between the three intestinal cleaning agents and the observation group(P < 0.05).(2)The tolerance rate of the three intestinal cleaning agents in the observation group was higher than that in the control group,and there was a statistically significant difference in the tolerance rate between the two groups for the use of intestinal detergent(P < 0.05).(3)The difference between the three intestinal cleaning agents and the control group in patients receiving colonoscopy was statistically significant(P < 0.05).(4)TThere were significant differences in the quality of bowel preparation between the three intestinal cleaning agents and the observation group(P < 0.05).(5)The detection rate of colorectal polyps in the observation group was higher than that in the control group,and the detection rate of colorectal polyps in the two groups was statistically significant(P < 0.05).Conclusion: 1,The old age,constipation,cerebrovascular accident history,not required to complete the bowel preparation is an independent factor for poor quality of bowel preparation.2,Individualized intervention to improve bowel preparation for patients taking polyethylene glycol electrolyte powder,Sodium Phosphate Oral Soulution,Mannitol Injection for the bowel preparation tolerance rate,improve the quality of bowel preparation,including the use of polyethylene glycol electrolyte powder in bowel preparation of patients improved the most obvious effect.3,Improving the quality of bowel preparation is beneficial to improve the tolerance of colonoscopy and the detection rate of colorectal polyps and to improve the quality of colonoscopy.