The Study On The Influence Of Different Intervention Methods On The Quality Of Bowel Preparation For Colonoscopy Diagnosis And Treatment Of Inpatients

Objective:To understand the difference of bowel preparation between inpatient and outpatient,and to analyze the influence factors of the quality of bowel preparation for inpatient.Furthermore,the experiment was conducted to further explore whether exercise during Polyethylene glycol(PEG)administration could improve the quality of bowel preparation of inpatients.Therefore,provide the best bowel preparation scheme for inpatients.Methods:1.Convenience sampling method was adopted to select 220 inpatients(in the inpatient group)and 227 outpatients(in the outpatient group)who planned to receive colonoscopy diagnosis and treatment in the digestive endoscopy center of a tertiary hospital from January to April,2018.The baseline data of questionnaire to understand the general situation of patients,adopted the influencing factors for bowel preparation feedback form to understand the patient's bowel preparation,rating scale for bowel preparation by Ottawa Bowel Preparation Scale scored of the quality of bowel preparation in the two groups,multiple linear regression analysis was used to analyze the influencing factors of bowel preparation quality in inpatients.2.The effect of exercise on the quality of bowel preparation in hospitalized patients was discussed in this study.From May to August 2018,528 inpatients attended colonoscopy in a tertiary hospital were randomly assigned to two groups.Participants in control group ingested 2L PEG solution in 2h,oral administration at a rate of about 1L per hour,and asked them to walk as much as possible during take the PEG until they discharged clear water stool.Participants in experimental group,at the first time ingested 750 ml PEG solution in 10 minutes,and then at a rate of 250 ml every 5 minutes,and walked 15 minutes after ingested each liter of PEG solution,until they discharged clear water stool,walking speed is 107±20 steps per minute and walking at least 1.5 hours.A more than 5 years experienced endoscopist evaluated the quality of bowel cleansing according to OBPS and recorded the colonoscopy start time and the tine to ileocecal.A questionnaire including demographic and clinical data,the influencing factors of bowel preparation,adverse reactions to PEG,preoperative anxiety level and postoperative exhaust time were compared between the two groups.Results:1.In the comparison of baseline data,there were statistically significant differences between the two groups were history of colonoscopy,indication for colonoscopy and the history of disease(P<0.01).In the comparison of bowel preparation factors data,the temperature of the water when taking the PEG,the two days before colonoscopy whether exercised 1.5 h/d,the low fiber diet time before colonoscopy of the two days,the steps from started taking PEG to discharge clear water stool,the frequency of bowel activity after taking the PEG,the first bowel activity after taking the PEG,the time interval between bowel preparation and colonoscopy,when discharge residue stool after taking PEG and the sleep before the colonoscopy,the nine factors between the two groups was statistically significant difference(P<0.01);Multivariate linear regression analysis showed that the steps from started taking PEG to discharge clear water stool,the frequency of bowel activity after taking the PEG,the time interval between bowel preparation and colonoscopy,when discharge residue stool after taking the PEG,and the two days before colonoscopy whether exercised 1.5h/d are the factors of inpatients with inadequate bowel preparation(P<0.05).2.There was no significant difference between the two groups in baseline data such as gender,education level,age,BMI(P>0.05).The results statistically significant difference in OBPS scores,intestinal motility,preoperative anxiety level,adverse reactions to PEG,intraoperative time to ileocecal and postoperative exhaust time between the two groups(P<0.05).Conclusion:1.The steps from started taking PEG to discharge clear water stool,the frequency of bowel activity after taking the PEG,the time interval between bowel preparation and colonoscopy,when discharge residue stool after taking PEG,the two days before colonoscopy whether exercised 1.5 h/d were the influence factors of bowel preparation in inpatients.2.Exercise can improve the intestinal cleanliness,promote peristalsis,relieve preoperative anxiety,shorten the time to reach ileocecal part,accelerate postoperative exhaust and reduce the incidence of adverse reactions after taking the PEG in hospitalized patients.