溃疡性结肠炎患者结肠镜检查肠道准备不充分的影响因素分析

Influencing factors of inadequate bowel preparation for colonoscopy in patients with ulcerative colitis

摘要:

为探讨溃疡性结肠炎（ulcerative colitis，UC）患者结肠镜检查肠道准备情况和肠道准备不充分的影响因素，并制定相应策略，回顾2023年1月至2024年3月于长海医院消化内镜中心行结肠镜检查的207例UC患者资料，提取患者基本信息、内镜诊查报告及波士顿肠道准备量表（Boston bowel preparation scale，BBPS）评分等，随访院外信息。根据BBPS评分，分为肠道准备充分组和不充分组。采用logistic回归分析UC患者结肠镜检查肠道准备不充分的影响因素。结果显示，UC患者结肠镜检查肠道准备不充分率为9.2%（19/207）。合并糖尿病（P=0.013，OR=12.490，95%CI：1.718~90.784）、UC简易临床结肠炎活动指数（SCCAI）评分（P=0.029，OR=1.191，95%CI：1.018~1.394）和使用生物制剂（P=0.029，OR=12.416，95%CI：1.291~119.425）是肠道准备不充分的影响因素。SCCAI评分（r=-0.172，P=0.013）、Mayo内镜下评分（r=-0.259，P<0.001）、病变部位（r=-0.217，P=0.002）与BBPS评分呈负相关。可见，UC患者结肠镜检查过程中肠道准备的充分性仍有待提高。针对患有糖尿病、使用生物制剂以及SCCAI评分高的患者，应当采取一系列强化措施，以期有效降低肠道准备不充分率。

Abstract:

To investigate the preparation status and influencing factors of inadequate bowel preparation for colonoscopy in patients with ulcerative colitis (UC) and to formulate corresponding strategies, data from 207 UC patients who underwent colonoscopy at the Digestive Endoscopy Center of Changhai Hospital from January 2023 to March 2024 were retrospectively reviewed. Patients’ basic information, endoscopic examination reports, Boston bowel preparation scale (BBPS) scores, and follow-up outpatient information were extracted. Based on BBPS scores, patients were divided into an adequate bowel preparation group and an inadequate bowel preparation group. Logistic regression analysis was used to identify factors influencing inadequate bowel preparation. The results showed that the rate of inadequate bowel preparation was 9.2% (19/207). Combined with diabetes (P=0.013， OR=12.490, 95%CI:1.718-90.784), simple clinical colitis activity index (SCCAI) score for UC (P=0.029， OR=1.191, 95%CI:1.018-1.394), and use of biologics (P=0.029， OR=12.416, 95%CI:1.291-119.425) were significant influencing factors for inadequate bowel preparation. SCCAI score (r=-0.172, P=0.013), Mayo endoscopic score (r=-0.259,P<0.001), and lesion location (r=-0.217,P=0.002) were negatively correlated with BBPS score. In conclusion, the adequacy of bowel preparation during colonoscopy in UC patients still needs improvement. For patients with diabetes, those using biologics, and those with high SCCAI scores, a series of enhanced measures should be implemented to effectively reduce the rate of inadequate bowel preparation.