Patients With Chronic Constipation Prefer Intestinal Preparation And Intestinal Preparation And Analysis Of Factors Affecting Preparation Quality

Objective: Compare and observe the effects of five commonly used clinical programs on bowel preparation in patients with chronic constipation before colonoscopy,and identify the relevant factors that affect the quality of bowel preparation in patients with chronic constipation.Methods: Collect relevant data(age,gender,BMI,source,history of abdominal surgery,basics)of 365 cases of chronic constipation scheduled for colonoscopy at the Endoscopy Center of Shaanxi Provincial People's Hospital from May 2019 to November2019 according to inclusion and exclusion criteria Disease,type of medication,time of medication,last stool traits,amount of fluid taken during bowel preparation,complete medication,time of last stool from colonoscopy,etc.)Divide it into 5 groups according to the random number method,and use 5 different intestinal preparation schemes for intestinal preparation.Group A is the control group.Take 2L of compound polyethylene glycol –electrolyte orally twice a night before the examination lavage solution,PEG-ELS);Group B is divided oral 3L PEG-ELS in the first night;Group C is divided oral 2L PEG-ELS in the night before the examination + 1L PEG-ELS taken in divided doses on the day of examination;Group D For oral administration of 2L PEG-ELS in divided doses 1 night before the examination + 100 ml of lactulose solution in divided doses 1 day before the inspection;Group E for oral administration of 2L PEG-ELS in divided doses 1 night before the examination + 40 ml sodium glucoside 2 hours before colonoscopy anus.The quality of intestinal preparation of all patients was evaluated using the BBPS scoring standard.Chi-square test and analysis of variance were used tocompare the intestinal preparation quality,incidence of adverse reactions and polyp detection rate of five intestinal preparation programs.Intestinal preparation plan with low incidence of adverse reactions;Binary Logistic regression analysis of factors related to chronic constipation patients collected in the questionnaire to obtain the influencing factors of intestinal preparation in patients with constipation.Result:1.With 5 options,the intestinal sufficiency of group A is 64.8%,group B is86.3%,group C is 78.9%,87.3% in group D and 72.9% in group E,in which the quality of intestinal preparation in group D was the highest,the difference was statistically significant(P <0.05);2.Five options,the detection rate of polyps in group A is 8.5%,group B is 28.8%,group C is 22.5%,32.4% in group D and 27.1% in group E.The detection rate of polyps in group D was the highest,the difference was statistically significant(P <0.05);3.There were no serious adverse reactions during the intestinal preparation of the 5schemes.The main reactions were abdominal distension,abdominal pain,nausea,and vomiting;the incidence of adverse reactions during the intestinal preparation of the 5groups: 14.1% in group A,and 58.9%,group C 18.3%,group D 15.5%,group E 18.6%,among which group B had the highest incidence of adverse reactions,group A had the lowest incidence of adverse reactions,the difference was statistically significant(P<0.05);4.There was no significant difference in the tolerance level of the patients during the intestinal preparation of the 5 schemes(P = 0.163).5.In 5 schemes,the left semicolon intestinal preparation quality score of group E was higher than that of the other four groups,the difference was statistically significant(P <0.05);6.Comparing all groups with sufficient intestinal preparation and inadequate group of patients with chronic constipation,single-factor analysis of factors affecting the quality of intestinal preparation include: gender(P <0.001),whether they exerciseactively after taking the drug(P <0.001),and the amount of fluid taken during intestinal preparation(P <0.001),Last stool trait(P <0.001),time from enteroscopy(P = 0.014),constipation time(P = 0.026),bowel preparation plan(P = 0.043)after taking the drug;multi-factor analysis of the impact of bowel preparation quality Factors include: male(P= 0.013),no active exercise after taking the drug(P <0.001),non-clean water sample of the last stool(P = 0.010)Conclusion:1.2L PEG-ELS combined with 100 ml lactulose solution can improve the intestinal preparation quality and polyp detection rate of patients compared with the other four groups.2.Compared with the other four groups,2L PEG-ELS had the lowest incidence of adverse reactions during intestinal preparation,while the single-use 3L PEG-ELS had the highest incidence of adverse reactions.3.2L PEG-ELSL combined with 40 ml of Kaisailu(group E)left colonic bowel preparation quality is superior to the four groups,it is recommended that patients with a family history of rectal cancer and need to focus on the examination of left colonic lesions can use this method for bowel ready.4.Men,who do not exercise actively after taking the drug,and the last stool is not an independent water sample is an independent risk factor for inadequate intestinal preparation in patients with chronic constipation.Recognizing these factors is conducive to improving the quality of intestinal preparation in patients with chronic constipation.