关键词: 内窥镜检查, 胃肠道；住院病人；肠道准备；聚乙烯二醇类；影响因素分析

Abstract: Background　With the development of endoscopic diagnosis and treatment technology, colonoscopy has become the gold standard for colon cancer screening. Whether a patient's bowel preparation is adequate is closely related to the success of colonoscopy diagnosis and treatment.At present, there are few domestic and foreign studies on the status, cleanliness level and influencing factors of inpatients' bowel preparation.However, relevant studies have shown that the quality of bowel preparation of inpatients is worse than that of outpatients. Therefore, how to improve the quality of bowel preparation of inpatients remains to be studied, which has received extensive attention from scholars at home and abroad. Objective　To understand the difference in bowel preparation between inpatients and outpatients undergoing colonoscopy, and to analyze the influencing factors of bowel preparation of inpatients. Methods　From January to April 2018, a total of 447 inpatients and outpatients underwent colonoscopy in the Department of Gastroenterology, the Second Hospital of Hebei Medical University were selected by convenience sampling, with the outpatient group of 227 subjects and inpatient group of 220 subjects. Baseline data questionnaire and Activities of Daily Living（ADL） scale were used to understand the general situation of patients. The influencing factors of bowel preparation were studied by using the feedback table of influencing factors of bowel preparation, the bowel preparation quality scored by Ottawa Bowel Preparation Scale（OBPS）, and multiple linear regression was used to analyze the influencing factors of OBPS score in inpatients. Results　The rate of inadequate bowel preparation in the outpatient group was 23.3%（53/227） and in the inpatient group was 49.5%（109/220）. OBPS scores of right colon, transverse colon, left colon, fluid volume and OBPS total score in outpatient group were lower than those in inpatient group（P<0.05）．Nine factors，including the low fiber diet time before two days of colonoscopy, the movement steps from taking compound polyethylene glycol electrolyte powder（PEG） to discharging watery stools, 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, time for discharging residue after taking PEG, the sleep before the colonoscopy, the temperature of water and the exercise two days before colonoscopy, were significantly different between the two groups（P<0.05）; multivariate linear regression analysis showed that the movement steps from taking PEG to discharging watery stools（β=0，P<0.001）, the frequency of bowel activity after taking the PEG〔β=-0.042，95%CI（-0.078，-0.007），P=0.019〕, time for discharging residue after taking PEG〔β=0.136，95%CI（0.033，0.238），P=0.010〕, the exercise two days before colonoscopy〔β=0.302，95%CI（0.100，0.504），P=0.004〕were influencing factors in OBPS scores of the right colon in inpatients. The steps from taking PEG to discharging watery stools（β=0，P<0.001）was the factor influencing OBPS scores of transverse colon , left colon in inpatients.The steps from taking PEG to discharging watery stools（β=0，P<0.001）, the time interval between bowel preparation and colonoscopy〔β=-0.050，95%CI（-0.090，-0.009），P=0.017〕, time for discharging residue after taking PEG〔β=0.155，95%CI（0.045，0.264），P=0.006〕were the influencing factors in OBPS scores of fluid volume in inpatients.The steps from taking PEG to discharging watery stools（β=0，P<0.001）, the frequency of bowel activity after taking the PEG〔β=-0.105，95%CI（-0.193，-0.017），P=0.020〕, time for discharging residue after taking PEG〔β=0.481，95%CI（0.226，0.736），P<0.001〕and the exercise two days before colonoscopy〔β=0.681，95%CI（0.178，1.184），P=0.008〕were the influencing factors of OBPS total score in inpatients. Conclusion　The movement steps from taking PEG to discharging watery stools, the frequency of bowel activity after taking the PEG, the time interval between bowel preparation and colonoscopy, time to discharge residue after taking PEG and the exercise two days before colonoscopy were the influencing factors of bowel preparation in inpatients. Medical workers should take corresponding measures according to the influencing factors to reduce the impact of inadequate bowel preparation and ensure a smooth progress of colonoscopy diagnosis and treatment.

Key words: Endoscopy, gastrointestinal；Inpatients；Bowel preparation；Polyethylene glycols；Root cause analysis