肠道准备过程中不良反应的相关危险因素分析

Risk factors for adverse reactions during intestinal preparation for colonoscopy

摘要:

目的 探索结肠镜检查前肠道准备过程中出现的不良反应及其相关危险因素。方法 回顾性分析2019年9月至2021年3月在空军军医大学第一附属医院行结肠镜检查的1 727例患者的临床资料，主要研究终点为肠道准备过程中不良反应发生率，并通过Logistic回归分析发生不良反应的危险因素。结果 1 727例患者肠道准备过程中不良反应的发生率为54.9%（948/1 727），其中恶心、呕吐、腹部不适的发生率分别为38.6%（666/1 727）、10.2%（177/1 727）、25.9%（447/1 727）。多因素Logistic回归分析显示：女性（OR=1.77，95%CI：1.45~2.17，P<0.001）、有腹部或盆腔手术史（OR=1.38，95%CI：1.08~1.75，P=0.009）、患有炎症性肠病（OR=1.77，95%CI：1.08~2.91，P=0.024）是肠道准备过程中发生不良反应的独立危险因素；女性（OR=2.37，95%CI：1.66~3.38，P<0.001）、有腹部或盆腔手术史（OR=1.45，95%CI：1.02~2.06，P=0.038）是发生呕吐的独立危险因素，体重指数≥25 kg/㎡（OR=0.48，95%CI：0.28~0.80，P=0.005）、年龄≥60岁（OR=0.58，95%CI：0.38~0.89，P=0.013）是发生呕吐的保护因素。结论 肠道准备过程中不良反应的发生率较高。发生不良反应的危险因素包括女性、腹部或盆腔手术史、炎症性肠病；发生呕吐的危险因素包括女性、腹部或盆腔手术史，而肥胖和高龄是发生呕吐的保护因素。肠道准备期间应注意对以上因素的评估。

Abstract:

Objective To explore the adverse reactions and its risk factors during bowel preparation prior to colonoscopy. Methods The clinical data of 1 727 patients who underwent colonoscopy at the First Affiliated Hospital of Air Military Medical University from September 2019 to March 2021 were analyzed retrospectively. The primary endpoint was the incidence of adverse reactions during bowel preparation. The risk factors of adverse reactions were identified by logistic regressions. Results The incidence of overall adverse reactions was 54.9% (948/1 727). The incidences of nausea, vomiting, and abdominal discomfort were 38.6% (666/1 727) , 10.2% (177/1 727), 25.9% (447/1 727), respectively. Multivariate logistic regression analysis showed that being female (OR=1.77, 95%CI: 1.45-2.17, P<0.001), history of abdominal surgery (OR=1.38, 95%CI:1.08-1.75, P=0.009), inflammatory bowel disease (OR=1.77, 95%CI: 1.08-2.91, P=0.024) were independent risk factors for adverse reactions during bowel preparation. Female gender (OR=2.37, 95%CI: 1.66-3.38, P=0.001) and history of abdominal or pelvic surgery (OR=1.45, 95%CI: 1.02-2.06, P=0.038) were independent risk factors for vomiting, while body mass index ≥25 kg/㎡(OR=0.48, 95%CI: 0.28-0.80, P=0.005) and age≥60 years (OR=0.58, 95%CI: 0.38-0.89, P=0.013) were protective factors for vomiting during bowel preparation. Conclusion A significant portion of patients experience adverse reactions during bowel preparation for colonoscopy. The risk factors of adverse reactions include female, history of abdominal surgery and inflammatory bowel disease. Female and a history of abdominal surgery are independent risk factors for vomiting, while obesity and old age are protective factors for vomiting during bowel preparation.