以质量求发展，以服务铸品牌

护理学报 ›› 2021, Vol. 28 ›› Issue (9): 22-28.doi: 10.16460/j.issn1008-9969.2021.09.022

• 循证护理 • 上一篇    下一篇

成年患者结直肠镜检查肠道准备不充分的预防及管理证据总结

李萍1a, 靳小雯1a, 李燕玲1a, 徐玉兰1b, 喻姣花1b, 李卓颖1c, 李应2, 邓睿1d   

  1. 1.华中科技大学同济医学院附属协和医院 a.消化内科; b.护理部; c.西区骨科; d.内镜中心,湖北 武汉430056;
    2.武汉市中心医院 护理部,湖北 武汉430022
  • 收稿日期:2021-01-04 出版日期:2021-05-10 发布日期:2021-06-09
  • 通讯作者: 李燕玲(1976-),女,湖北武汉人,本科学历,副主任护师,护士长。
  • 作者简介:李萍(1988-),女,湖北武汉人,硕士,主管护师。
  • 基金资助:
    湖北省自然科学基金(2016CKB706)

Evidence Summary for Prevention and Management of Poor Bowel Preparation of Adult Patients with Colorectoscopy

LI Ping1a, JIN Xiao-wen1a, LI Yan-ling1a, XU Yu-lan1b, YU Jiao-hua1b, LI Zhuo-ying1c, LI Ying2, DENG Rui1d   

  1. 1a. Dept. of Gastroenterology; 1b. Dept. of Nursing Administration; 1c. Dept. of Orthopedics, West District; 1d. Dept. of Endoscopy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430056, China;
    2. Dept. of Nursing Administration, the Central Hospital of Wuhan, Wuhan 430022, China
  • Received:2021-01-04 Online:2021-05-10 Published:2021-06-09

PDF (PC)

124

赞

摘要： 目的 检索并获取行结直肠镜检查的成年患者肠道准备不充分的预防及管理的相关证据,为临床护理工作提供参考依据。方法 运用循证护理方法,针对行结直肠镜检查的成年患者肠道准备不充分的预防及管理提出问题,按照证据资源的“6S”金字塔模型检索文献,采用英国2012版的《临床指南研究与评价系统》、JBI循证卫生保健中心的文献评价标准和证据分级系统（2014版）以及Johns Hopkins医院的循证实践项目管理工具对各类文献进行质量评价和分级评定。结果 结合相关专业人员评定,汇总出22 条肠道准备不充分的预防及管理的证据,包括肠道准备不充分的评估;相关因素;方案的选择;不良事件的处理;饮食护理及健康教育6个方面。结论 本研究总结了结直肠镜检查的成年患者肠道准备质量不充分的预防及管理的最佳证据,为肠道检查患者实施机械肠道准备提供了循证依据,以科学的方法来管理肠道准备不充分的问题,提升护理质量。

关键词: 结直肠镜, 肠道准备, 肠道准备不充分, 护理质量, 循证护理学

Abstract: Objective To retrieve and obtain relevant evidence for the prevention and management of poor bowel preparation in adult patients with colonoscopy, and to provide reference for clinical nursing. Methods Evidence-based nursing methods were used to address the problems on the prevention and management of poor bowel preparation in adult patients with colonoscopy. The literature was retrieved according to the "6S" pyramid model of evidence resource, and the British 2012 version of "Clinical Guidelines Research and Evaluation System", literature evaluation standards and evidence grading system in JBI Evidence-Based Health Care Center (2014 version), and evidence-based practice project management tool in Johns Hopkins Hospital were used for quality evaluation and grading evaluation of the included studies. Results Combined with the assessment of professionals, 22 pieces of evidence for the prevention and management of poor bowel preparation were collected, including six aspectsinadequate intestinal preparation assessment; related factors; choice of program; treatment of adverse events; dietary care and health education. Conclusion This study summarizes the best evidence for the prevention and management of poor bowel preparation in adult patients with colonoscopy, and provides evidence-based basis for mechanical intestinal preparation for patients with colonoscopy, which is beneficial to improving the quality of nursing.

Key words: colonoscopy, bowel preparation, poor bowel preparation, the quality of nursing, evidence-based nursing

中图分类号: 

  • R473.6
[1] Global Burden of Disease Cancer Collaboration. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-adjusted Life -years for 29 Cancer Groups, 1990 to 2016: A Systematic Aanalysis for The Global Burden of Disease study[J]. JAMA Oncol, 2018,4(11):1553-1568.DOI:10.1001/jamaoncol.2018.2706.
[2] Antonio Z, Heuser B, et al.Reygosa C.Impact of A 1-day Versus 3-day Low-residue Diet on Bowel Cleansing Quality Before Colonoscopy: A Randomized Controlled Trial[J]. Endoscopy, 2019 ,51(7):706-707. DOI:10.1055/a-0942-8045.
[3] Heetun Z, Crowley R, Zed F, et al.Comparison of Polyethylene Glycol vs Sodium Picosulhate vs Sodium Biphoshonate by Efficacy in Bowel Cleaning and Atients, Tolerability:A Randomized Trial[J]. IrJMed Sc, 2016,185(3):629-633.DOI:10.1007/s11 845-015-1320-7.
[4] Hookey L, Haimanot S, et alMarchut K., More Is Not Always Better: A Randomized Trial of Low Volume Oral Laxative, Enemas, and Combination of Both Demonstrate That Enemas Alone Are Most Efficacious for Preparation for Flexible Sigmoidoscopy[J]. Clinical and Translational Gastroenterology,2016,7(3):e156. DOI:10.1038/ctg.2016.15.
[5] Maliampurakal AJ, Mcmillan DC, Anderson JH, et al.Factors Associated with The Efficacy of Polyp Detection during Routine Flexible Sigmoidoscopy[J].Frontline Gastroenterlogy.2018,9(2):135-142.DOI:10.1136/flgastro-2017-100849.
[6] 孙畅,何文英,王策,等. 住院患者肠道准备影响因素及相关护理干预的研究进展[J].护理学报,2018,10:41-44.DOI:10.16460/j.issn1008-9969.2018.10.041.
[7] 闫丽,杜红娣,卢静. 降低结肠镜患者肠道准备不合格率的品管圈实践[J]. 护理学报,2017,13:45-48.DOI:10.16460/j.issn1008-9969.2017.13.045.
[8] Hassan C, East J, Radaelli F, et al.Bowel Preparation for Colonoscopy:European Society of Gastrointestinal Endoscopy (ESGE)Guideline-Update 2019[J]. Endoscopy, 2019,51(8):775-794. DOI:10.1055/a-0959-0505.
[9] Migaly J, Bafford AC, Francone TD,et al.The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Use of Bowel Preparation in Elective Colon and Rectal Surgery[J]. Elictive Surgery Bowel Preparation,2019,62:3-8.DOI:10.1097/DCR.0000000000001238.
[10] 柏愚,陈卫刚,陈幼祥,等.中国消化内镜诊疗相关肠道准备指南(2019,上海)[J].中华内科杂志,2019,58(7):485-495.DOI:10.3760/cma.j.issn.0578?1426.2019.07.002.
[11] 朱政,胡雁,邢唯杰,等.不同类型循证问题的构成[J].护士进修杂志,2017, 32(21):1991-1994.DOI:10.16821/cnki.hsjx.2017.21.025.
[12] Dicenso A, Bayley L, Haynes RB.Accessing Preappraised Evidence :Fine-tuning the 5S Model into a 6S Model[J]. Evid Based Nurs,2009, 12(4):99-101.DOI:10.1136/ebn.12.4.99-b.
[13] Brouwers MC, Kho ME, Browman GP, et al.AGREE Ⅱ:Advancing Guideline Development, Reporting, and Evaluation in Health Gare[J].Prev Med, 2010,51(5):421-424.DOI:10.1016/j.jclinepi.2010.07.001.
[14] The Joanna Briggs(JBI). Checklist for Systematic Reviews and Research Syntheses[EB/OL].[2016-12-03](2019-07-10).http://joanna briggs.org/research/critical-appraisal-tools.html.
[15] Sandra L, Deborah D.Johns Hopkins Nursing Evidence-based Practice Model and Guidelines[M]. Indiana :Sigma Theta Tau International,2007:204-207.
[16] 杨中善,许妮娜,詹昱新,等.住院患者规范化身体约束管理最佳证据总结[J].护理学报,2019,26(4):31-36.DOI:10.16460/j.issn1180-19969.16404.16031.
[17] 胡雁,郝玉芳.循证护理学[M].2版.北京:人民卫生出版社, 2018.
[18] Chou CK, Chang CY, et al.Chang CC.Controlled Dietary Restriction with A Prepackaged Low-residue Diet before Colonoscopy Offers Better-quality Bowel Cleansing and Allows the Use of a Smaller Volume of Purgatives: A Randomized Multicenter Trial[J].Diseases of the Colon Rectum Volume,2016, 59(10):975-983.DOI:10.1097/DCR.0000000000000675.
[19] Ergen WF, Pasricha T, Hubbard, FJ,et al.Providing Hospitalized Patients with An Educational Booklet Increases The Quality of Colonoscopy Bowel Preparation[J]. Clinical Gastroenterology and Hepatology,2016,14:858-864.DOI:10.1016/j.cgh.2015.11.015.
[20] Zhang SZ, Li M, Zhao YG,et al. 3-L Split-dose is Superior to 2-L Polyethylene Glycol in Bowel Cleansing in Chinese Population[J].Medicine,2015, 94(4)1-8.DOI:10.1097/MD.0000000000000472.
[21] Fernando J, Castro, Baker Al-Khairi,et al. Randomized Controlled Trial: Split-dose and Sameday Large Volume Bowel Preparation for Afternoon Colonoscopy Have Similar Quality of Preparation[J]. Clin Gastroentero, 2019,53(10):724-730.DOI:10.1097/MCG.0000000000001213.
[22] Menacho AM,Reimann A, Hirata LM,et al.Double-Blind Prospective Randomized Study Comparing Polyethylene Glycol to Lactulose for Bowel Preparation in Colonoscopy[J].ABCD Arq Bras Cir Dig,2014,27(1):9-12.DOI:10.1590/s010267202014000100003.
[23] Seo M, Gweon TG, Huh CW, et al.Comparison of Bowel Cleansing Efficacy, Safety, Bowel Movement Kinetics, and Patient Tolerability of Same-day and Split-dose Bowel Preparation Using 4L of Polyethylene Glycol: A Prospective Randomized Study[J]. Disease of the Colon Rectum,2019,62(12):1518-1527.DOI:10.1097/DCR.0000000000001499.
[24] Perreault G, Goodman A, et al.Larion S.Split-versus Single Dose Preparation Tolerability in A Multiethnic Population: Decreased Side Effects but Greater Social Barriers[J]. Ann Gastroenterol, 2018,31(3):356-364.DOI:10.20524/aog.2018.0254.
[25] Park SS, Sinn DH, et al.Kim YH.Efficacy and Tolerability of Split-dose Magnesium Citrate: Low-volume (2 Liters) Polyethylene Glycol VS Single-or Split-Dose Polyethylene Glycol Bowel Preparation for Morning Colonoscopy[J]. AmJGastroenterol,2015,105:1319-1326.DOI:10.1038/ajg.2015.79.
[26] Kang MK, Jang BL, et al.Park JS.Efficacy of Ramosetron in Combination with Polyethylene Glycol of Preparing for A Colonoscopy[J].Yeungnam UnivJMed,2019,36(2):99-104.DOI:10.12701/yujim.2019.00080.
[27] Chaussade S, Schmöcker C, Toulemonde P, et al.Phosphate Tablets or Polyethylene Glycol for Preparation to Colonos-copy?A Multicentre Non-inferiority Randomized Controlled Trial[J]. Surg Endosc, 2017,31(5):2166-2173. DOI:10.1007/s00464-016-5214-1.
[28] Audrey H, Edwin C.A Study of The Efficacy and Patient To lerance of Three Bowel Preparations for Colonoscopy[J]. Gastroenterology Nursing,2015,29(4):307-314.DOI:10.1016/j.gie.2015.10.013.
[29] Parmar R, Martel M,Rostom AR.Validated Scales for Colon Cleansing: A Systematic Review[J]. Gastroenterology,2016,111:197-204.DOI:10.1038/ajg.2015.417.
[30] Dahabreh IJ, Steele DW, Shah N, et al.Oral Mechanical Bowel Preparation for Colorectal Surgery: Systematic Review and Meta-analysis[J]. Disease of the Colon Rectum,2015,58(7):698-707.DOI:10.1097/DCR.0000000000000375.
[31] Tan L, Lin ZC, Ma S,et al.Bowel Preparation for Colonoscopy. Cochrane Database of Systematic Reviews[EB/OL].(2017-09-21)[2018-11-07].https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006330.pub3/full.DOI:10.1002/14651858.CD006330.pub3.
[32] Rai T, Navaneethan U, Gohel T,et al.Effect of Quality of Bowel Preparation on Quality Indicators of Adenoma Detection Rates and Colonoscopy Completion Rates[J]. Gastroenterology Report,2016,4(2):148-153. DOI:10.1093/gastro/gov002.
[33] Lamerato L, Witbrodtr E, Kau M,et al.Impact of Opioid Use on Patients Undergoing Screening Colonoscopy According to the Quality of Bowel Preparation[J]. Gastroenterology and Hepatology,2019,4(3):490-496. DOI:10.1002/jgh3.12288.
[34] Tariq H, Kamal MU, et al.Sapkota B.Evaluation of the Combined Effect of Factors Influencing Bowel Preparation and Adenoma Detection Rates in Patients Undergoing Colonoscopy[J]. BMJ Open Gastro, 2019,6(1):e000254. DOI:10.1136/bmj open gastro-2018-000254.
[35] Sajid MS, Caswell JF, Abbas MA, et al.Improving the View During Flexible Sigmoidoscopy: A Systematic Review of Published Randomized, Controlled Trials Comparing The Use of Oral Bowel Preparation Versus Enema Bowel Preparation[J]. Updates Surg,2015,67(3) :247-256.DOI:10.1007/s13304-015-0295-2.
[36] Blanc MC, Slim M, Berjot LB.Best Practices In Bowel Preparation for Colorectal Surgery: A 2020 Overview. Expert Review of Gastroenterology Hepatology[J]. 2020,14(8):681-688. DOI:10.1080/17474124.2020.1775581.
[37] Lee YJ, Kim ES, Choi JH, et al.Impact of Reinforced Education by Telephone and Short Message Service on The Quality of Bowel Preparation: A Randomized Con-Trolled Study[J]. Endoscopy,2015,47:1018-1027. DOI:10.1055/s-0034-1392406.
[1] 吴晓珩, 杨元立, 胡馨予, 王翠萍, 张萦, 王艳春, 陶艳玲. 住院患者输血全流程管理的循证实践[J]. 护理学报, 2021, 28(8): 33-38.
[2] 徐秋香, 马森, 刘箐. 麻醉恢复室护理质量敏感性指标的构建[J]. 护理学报, 2021, 28(3): 6-9.
[3] 傅晓珍, 李志飞, 陈丽君, 陈谦. 儿科协商引导式分段目标管理实践[J]. 护理学报, 2021, 28(10): 24-27.
[4] 杨力敏, 郑瑾. 加速康复外科护理模式在前列腺癌根治围手术期的实施与效果评价[J]. 护理学报, 2020, 28(最新录用): 14-17.
[5] 马莹, 叶君荣, 黄昭君, 夏志春, 徐丹, 邓爱萍, 刘名河, 罗斯莉, 张建龙. 基于循证构建精神科护理质量敏感性指标[J]. 护理学报, 2020, 27(9): 27-32.
[6] 刘颖, 黎丹, 黄燕波, 王倩, 贯华. 优化术前肠道准备方案对根治性膀胱全切加回肠通道术患者的影响[J]. 护理学报, 2020, 27(9): 68-70.
[7] 裴坤一, 郑欣, 徐柳, 李霞. 基于Servqual模型构建急性酒精中毒护理质量评价体系[J]. 护理学报, 2020, 27(7): 25-29.
[8] 王焕焕, 程湘玮, 王培红, 丁颖, 周英凤, 张纹, 熊彩霞, 吕永利, 屠凤鸣. 妊娠期糖尿病产妇分娩新生儿低血糖管理的最佳证据总结[J]. 护理学报, 2020, 27(3): 31-36.
[9] 彭瑶瑶, 师正燕, 李晓玲. 根治性膀胱切除术术前肠道准备的研究进展[J]. 护理学报, 2020, 27(20): 27-31.
[10] 林俏, 张广清, 刘梅娟, 黄颖, 刘丹阳, 刘玉萍, 邢同印, 陈继华. 成人结肠镜检查前肠道准备的最佳证据总结[J]. 护理学报, 2020, 27(16): 28-34.
[11] 张苗, 聂燕, 刘洁, 薛鲜敏. 首次肠道准备患者应用床旁智能交互系统视频宣教的效果观察[J]. 护理学报, 2020, 27(15): 74-76.
[12] 王潇. 应用“结构-过程-结果”理论构建蛇串疮中医药护理质量评价体系[J]. 护理学报, 2020, 27(1): 12-15.
[13] 张萍, 徐中芹, 苏洁, 迮露. 结肠镜前肠道准备评估单的设计与应用[J]. 护理学报, 2019, 26(7): 57-60.
[14] 刘红艳, 肖黎. 结构-过程-结果三维质量评价模式在肾移植术后腹泻患者中的应用[J]. 护理学报, 2019, 26(6): 19-21.
[15] 武艳, 徐琴, 周春苗, 董娟, 胡思萍, 袁昌平. 婴幼儿经鼻气管插管护理质量评价指标体系的构建[J]. 护理学报, 2019, 26(23): 25-28.
Viewed
Full text


Abstract

Cited
  Shared   
[1] 卢舒颖, 刘宁, 魏璐华, 梁冬梅, 李妍. 产后出血预防及管理的最佳证据总结[J]. 护理学报, 2020, 27(12): 18 -22 .
[2] 刘小成, 应文娟, 刘智利, 郑锐华, 许诺, 刘慧. 生命末期患者性与亲密关系评估的最佳证据总结[J]. 护理学报, 2020, 27(12): 23 -27 .
[3] 林慧菁, 倪平. 932名武汉市民对生命维持治疗的态度现状及影响因素分析[J]. 护理学报, 2020, 27(12): 28 -32 .
[4] 朱一凡, 陈芷谦, 郭巧红, 苏娅丽. 196例乳腺癌化疗患者尊严现状及影响因素分析[J]. 护理学报, 2020, 27(12): 33 -37 .
[5] 潘国翠, 李梅. 决策疲劳量表的汉化及其应用于ICU患者家属的信度效度评价[J]. 护理学报, 2020, 27(12): 38 -41 .
[6] 贺芳, 温秀兰, 林艳, 刘会, 郭晓萍, 张喆. 新生儿重症监护病房噪音水平调查与对策[J]. 护理学报, 2020, 27(12): 42 -45 .
[7] 田凡立, 李惠玲, 杜美兰, 蒋芳琴, 张新梅, 殷雪群. 新型冠状病毒肺炎下援鄂男护士情绪体验的质性研究[J]. 护理学报, 2020, 27(12): 46 -49 .
[8] 陈莹, 张国龙, 李平东, 阮亮, 卢玉娴, 原少清, 孙妃娥, 牟晓玲, 黄丹霞, 李润, 宫玉翠. 胸外科肿瘤手术患者新型冠状病毒肺炎疫情期间的防控管理与体会[J]. 护理学报, 2020, 27(12): 50 -53 .
[9] 张艳, 魏丽丽, 李环廷, 王刚, 杨海朋, 潘月帅, 王静远, 李倩倩. 新型冠状病毒肺炎定点收治医院隔离病房医护人员心理体验的质性研究[J]. 护理学报, 2020, 27(12): 54 -57 .
[10] 徐小玲, 崔亮, 叶泳松, 刘岘, 刘波. 自制简易面罩防控新型冠状病毒[J]. 护理学报, 2020, 27(12): 58 -59 .