老年无痛胃肠镜检查患者肠道准备失败的影响因素模型及干预策略研究
DOI:
作者:
作者单位:

1.联勤保障部队第九四〇医院消化内科;2.联勤保障部队第九四〇医院内镜中心;3.联勤保障部队第九四〇医院输血科

作者简介:

通讯作者:

中图分类号:

基金项目:

甘肃省自然基金项目(21JR1RA183) 甘肃省卫生健康委员会项目(GSWSKY2021-044)


Author:
Affiliation:

1.GastroenterologyThe 940th Hospital of Joint Logistics Support force of Chinese Peoples Liberation Army;2.Endoscopy CenterThe 940th Hospital of Joint Logistics Support force of Chinese Peoples Liberation Army;3.Transfusion DepartmentThe 940th Hospital of Joint Logistics Support force of Chinese Peoples Liberation Army

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    摘要:目的 探讨老年无痛胃肠镜检查患者肠道准备失败的影响因素,并构建风险预测模型。方法 回顾性分析2020年6月至2023年9月在我院进行无痛胃肠镜检查的412例老年患者一般临床资料,随机选取2/3患者纳入测试组(n=275),余下1/3患者纳入验证组(n=137),将测试组中患者根据肠道准备质量分为两个亚组,将肠道准备成功组纳入成功组(n=178),将肠道准备失败者纳入失败组(n=97),比较两组一般资料,采用SPSS 20.0统计软件分析数据。并根据数据类型,分别采用t检验或χ2检验进行组间比较。采用多因素logistic回归分析老年无痛胃肠镜检查患者肠道准备失败的影响因素,并以危险因素构建风险预测模型。采用Hosmer-Lemeshow 检验验证预测效能。结果 组间体质量指数、行走情况、便秘、结直肠手术史、首次进行结肠镜检查、服用三环类抗抑郁药、大量腹水、腹部/盆腔手术史、基础病种类资料比较差异显著(t=4.930、5.291、4.930、15.237、12.568、15.237、9.507、5.433、5.757,P<0.05);多因素logistic回归分析发现,便秘(OR:4.384,95%CI:1.136~16.919)、结直肠手术史(OR:4.043,95%CI:1.392~11.743)、服用三环类抗抑郁药(OR:5.013,95%CI:1.237~20.317)、基础病种类≥2种(OR:4.973,95%CI:1.335~18.526)是老年无痛胃肠镜检查患者肠道准备失败的独立危险因素(P<0.05);以危险因素代入风险预测模型,发现上述因素在老年无痛胃肠镜检查患者肠道准备失败中的预测敏感度68.42%、特异度为72.86%,AUC为0.739;验证组检验结果发现,Hosmer-Lemeshow χ2检验结果显示,χ2=4.136,P=0.840,敏感度67.99%、特异度为71.43%,AUC为0.732。结论 便秘、结直肠手术史、服用三环类抗抑郁药、基础病种类≥2种均会对老年胃肠镜检查患者肠道准备质量产生影响,且以上述因素构建的风险预测模型在老年胃肠镜检查患者肠道准备失败中预测效能较佳,临床需根据实际情况提出针对性干预方案,提高肠道准备质量。

    Abstract:

    Abstract: Objective To investigate the factors influencing the failure of intestinal preparation in elderly patients with painless gastroenteroscopy and establish a risk prediction model. Methods General clinical data of 412 elderly patients undergoing painless gastroenteroscopy in our hospital from June 2020 to September 2023 were retrospectively analyzed. 2/3 patients were randomly selected to be included in the test group (n=275), and the remaining 1/3 patients were included in the verification group (n=137). Patients in the test group were divided into two subgroups according to the quality of intestinal preparation. The successful bowel preparation group was included in the successful group (n=178), and the unsuccessful bowel preparation group was included in the failed group (n=97). SPSS 20.0 statistical software was used to analyze the data. According to the data type, t test or χ2 test were used to compare the data between groups. Multivariate logistic regression was used to analyze the influencing factors of intestinal preparation failure in elderly patients with painless gastroenteroscopy, and the risk prediction model was built based on the risk factors, and targeted intervention strategies were proposed.Hosmer-Lemeshow test was used to verify the prediction efficiency. Result There were significant differences in body mass index, walking status, constipation, history of colorectal surgery, first colonoscopy, tricyclic antidepressants, massive ascites, history of abdominal/pelvic surgery, and types of underlying diseases among groups (t=4.930, 5.291, 4.930, 15.237, 12.568, 15.23) 7, 9.507, 5.433, 5.757, P < 0.05); logistic regression analysis showed that constipation (OR: 4.384, 95%CI: 1.136-16.919), history of colorectal surgery (OR: 4.043, 95%CI: 1.392-11.743), tricyclic antidepressants (OR: 5.013, 95%CI: 1.237-20.317), type of underlying disease ≥2 (OR: 4.973, 95%CI: 1.335 ~ 18.526) was an independent risk factor for intestinal preparation failure in elderly patients with painless gastroenteroscopy (P < 0.05). When risk factors were substituted into the risk prediction model, it was found that the sensitivity, specificity and AUC of the above factors were 68.42%, 72.86% and 0.739 in the prediction of intestinal preparation failure in elderly patients with painless gastroenteroscopy. Conclusion Constipation, history of colorectal surgery, taking tricyclic antidepressants, and type of underlying disease ≥2 all have an impact on the quality of intestinal preparation in elderly patients with gastroenteroscopy, and the risk prediction model built based on the above factors has a better predictive effect on intestinal preparation failure in elderly patients with gastroenteroscopy. Targeted intervention plans should be proposed according to the actual situation in clinical practice to improve the quality of intestinal preparation.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2024-03-11
  • 最后修改日期:2024-05-14
  • 录用日期:2024-06-05
  • 在线发布日期:
  • 出版日期: