结肠镜肠道准备期间膳食营养摄入状况调查
|
摘要
目的调查结肠镜肠道准备期间膳食营养摄入状况。方法采用横断面调查研究2018年8月接受结肠镜肠道准备的患者96例,采用24 h膳食回顾法调查结肠镜检查前1 d进行饮食限制期间膳食摄入情况,计算能量和蛋白质实际摄入量;采用主观综合性营养评估法(SGA)评价患者营养状况;采用渥太华肠道准备评分量表(OBPS)评价肠道准备质量。将能量和蛋白质实际摄入量与《中国居民膳食营养素参考摄入量》推荐的目标值进行比较,并分析性别、年龄、就诊形式、营养状况对结肠镜肠道准备期间能量和蛋白质摄入状况的影响,以及肠道准备质量与膳食营养摄入状况是否相关。结果 96例患者中,男58例(60.4%),女38例(39.6%),年龄25～77(60.7±11.5)岁。结肠镜肠道准备期间能量[(1 394.6±452.8)kJ/24 h vs(2 267.7±366.7)kJ/24 h]和蛋白质[(46.8±15.4)g/24 h vs(61.0±4.9)g/24 h]实际摄入量均显著低于目标值(P<0.01),分别仅占目标值的61.5%和76.8%。膳食能量和蛋白质摄入个体达标率分别仅为52.1%和67.7%。老年(年龄≥65岁)和营养不良患者肠道准备饮食限制期间能量和蛋白质摄入不足的比例更高(P<0.05,P<0.01),肠道准备质量与膳食营养摄入状况均无相关性(P>0.05)。结论结肠镜肠道准备期间患者营养摄入不足的比例较高,尤以老年和营养不良患者最为突出,营养摄入量并不影响肠道准备质量,应尽快妥善解决结肠镜肠道准备期间营养摄入不足的问题。
Objective To investigate the dietary nutrition intake during colonoscopy preparation.Methods A cross-sectional study was conducted in 96 patients undergoing colonoscopy bowel preparation in August 2018.Dietary intake during 24-hour dietary restriction period before colonoscopy was investigated by 24-hour dietary retrospective method to calculat actual intake of energy and protein.The nutritional status of patients and the quality of intestinal preparation were evaluated respectively by subjective comprehensive nutrition assessment(SGA) and ottawa intestinal preparation scale(OBPS).The actual intake of energy and protein was compared with the target value recommended by "Reference Intake of Dietary Nutrients for Chinese Residents".The influences of gender,age,form of consultation and nutritional status on the intake of energy and protein during colonoscopy bowel preparation was analyzed,and it was also studied whether the quality of bowel preparation was related to the intake of dietary nutrients.Results There were 58 males(60.4%) and 38 females(39.6%),aged from 25 to 77(60.7 ± 11.5)years.The actual intakes of energy [(1 394.6±452.8)kJ/24 h vs(2 267.7±366.7)kJ/24 h] and protein[(46.8±15.4)g/24 h vs(61.0 ± 4.9)g/24 h] were significantly lower than the target values(P<0.01) and were only 61.5% and 76.8% of the target values,respectively.The individual standard-reaching rates of energy and protein intake were only 52.1% and 67.7%,respectively.The proportion of inadequate intake of energy and protein was significantly higher in elderly(age≥65 years) and malnutrition patients(P<0.05,P<0.01).There was no obvious correlation between bowel preparation quality and dietary nutrition intake(P>0.05).Conclusions The proportion of nutritional intake insufficiency during colonoscopy bowel preparation is higher,especially in elderly and malnourished patients.Nutritional intake has no impact on the quality of bowel preparation.The problem of nutritional intake insufficiency during colonoscopy bowel preparation should be properly solved as soon as possible.
Objective To investigate the dietary nutrition intake during colonoscopy preparation.Methods A cross-sectional study was conducted in 96 patients undergoing colonoscopy bowel preparation in August 2018.Dietary intake during 24-hour dietary restriction period before colonoscopy was investigated by 24-hour dietary retrospective method to calculat actual intake of energy and protein.The nutritional status of patients and the quality of intestinal preparation were evaluated respectively by subjective comprehensive nutrition assessment(SGA) and ottawa intestinal preparation scale(OBPS).The actual intake of energy and protein was compared with the target value recommended by "Reference Intake of Dietary Nutrients for Chinese Residents".The influences of gender,age,form of consultation and nutritional status on the intake of energy and protein during colonoscopy bowel preparation was analyzed,and it was also studied whether the quality of bowel preparation was related to the intake of dietary nutrients.Results There were 58 males(60.4%) and 38 females(39.6%),aged from 25 to 77(60.7 ± 11.5)years.The actual intakes of energy [(1 394.6±452.8)kJ/24 h vs(2 267.7±366.7)kJ/24 h] and protein[(46.8±15.4)g/24 h vs(61.0 ± 4.9)g/24 h] were significantly lower than the target values(P<0.01) and were only 61.5% and 76.8% of the target values,respectively.The individual standard-reaching rates of energy and protein intake were only 52.1% and 67.7%,respectively.The proportion of inadequate intake of energy and protein was significantly higher in elderly(age≥65 years) and malnutrition patients(P<0.05,P<0.01).There was no obvious correlation between bowel preparation quality and dietary nutrition intake(P>0.05).Conclusions The proportion of nutritional intake insufficiency during colonoscopy bowel preparation is higher,especially in elderly and malnourished patients.Nutritional intake has no impact on the quality of bowel preparation.The problem of nutritional intake insufficiency during colonoscopy bowel preparation should be properly solved as soon as possible.
引文
[1] Bechtold ML,Mir F,Puli SR,et al.Optimizing bowel preparation for colonoscopy:a guide to enhance quality of visualization[J].Ann Gastroenterol,2016,29(2):137-146.
[2] Nguyen DL,Jamal MM,Nguyen ET,et al.Low-residue versus clear liquid diet before colonoscopy:a meta-analysis of randomized,controlled trials[J].Gastrointest Endosc,2016,83(3):499-507.
[3] Avalos DJ,Sussman DA,Lara LF,et al.Effect of diet liberalization on bowel preparation[J].South Med J,2017,110(6):399-407.
[4] 何宇纳,赵丽云,于冬梅,等.2010-2012年中国成年居民蔬菜和水果摄入状况[J].中华预防医学杂志,2016,50(3):221-224.
[5] Stolpman DR,Solem CA,Eastlick D,et al.A randomized controlled trial comparing a low-residue diet versus clear liquids for colonoscopy preparation:impact on tolerance,procedure time,and adenoma detection rate[J].J Clin Gastroenterol,2014,48(10):851-855.
[6] Song GM,Tian X,Ma L,et al.Regime for bowel preparation in patients scheduled to colonoscopy:low-residue diet or clear liquid diet?Evidence from systematic review with power analysis[J].Medicine (Baltimore),2016,95(1):e2432.
[7] Hassan C,Bretthauer M,Kaminski MF,et al.Bowel preparation for colonoscopy:European Society of Gastrointestinal Endoscopy(ESGE) guideline[J].Endoscopy,2013,45(2):142-150.
[8] Saltzman JR,Cash BD,Pasha SF,et al.Bowel preparation before colonoscopy[J].Gastrointest Endosc,2015,81(4):781-794.
[9] 中华医学会消化内镜学分会.中国消化内镜诊疗相关肠道准备共识意见[J].中华消化内镜杂志,2013,30(10):541-549.
[10] Nunes G,Barata AT,Santos CA,et al.Nutritional deficiency during colonoscopy preparation:the forgotten iatrogeny[J].Rev Esp Enferm Dig,2018,110(5):285-291.
[11] Dami?o R,Meneguci J,da Silva Santos á,et al.Nutritional risk and quality of life in community-dwelling elderly:a cross-sectional study[J].J Nutr Health Aging,2018,22(1):111-116.
[12] Baugreet S,Hamill RM,Kerry JP,et al.Mitigating nutrition and health deficiencies in older adults:a role for food innovation?[J].J Food Sci,2017,82(4):848-855.
[13] Cohen LB.Advances in bowel preparation for colonoscopy[J].Gastrointest Endosc Clin N Am,2015,25(2):183-197.
[14] Yao JF,Zhang W,Chen J,et al.Enteral nutrition before bowel preparation improves the safety of colonoscopy in the elderly[J].Turk J Gastroenterol,2013,24(5):400-405.
[2] Nguyen DL,Jamal MM,Nguyen ET,et al.Low-residue versus clear liquid diet before colonoscopy:a meta-analysis of randomized,controlled trials[J].Gastrointest Endosc,2016,83(3):499-507.
[3] Avalos DJ,Sussman DA,Lara LF,et al.Effect of diet liberalization on bowel preparation[J].South Med J,2017,110(6):399-407.
[4] 何宇纳,赵丽云,于冬梅,等.2010-2012年中国成年居民蔬菜和水果摄入状况[J].中华预防医学杂志,2016,50(3):221-224.
[5] Stolpman DR,Solem CA,Eastlick D,et al.A randomized controlled trial comparing a low-residue diet versus clear liquids for colonoscopy preparation:impact on tolerance,procedure time,and adenoma detection rate[J].J Clin Gastroenterol,2014,48(10):851-855.
[6] Song GM,Tian X,Ma L,et al.Regime for bowel preparation in patients scheduled to colonoscopy:low-residue diet or clear liquid diet?Evidence from systematic review with power analysis[J].Medicine (Baltimore),2016,95(1):e2432.
[7] Hassan C,Bretthauer M,Kaminski MF,et al.Bowel preparation for colonoscopy:European Society of Gastrointestinal Endoscopy(ESGE) guideline[J].Endoscopy,2013,45(2):142-150.
[8] Saltzman JR,Cash BD,Pasha SF,et al.Bowel preparation before colonoscopy[J].Gastrointest Endosc,2015,81(4):781-794.
[9] 中华医学会消化内镜学分会.中国消化内镜诊疗相关肠道准备共识意见[J].中华消化内镜杂志,2013,30(10):541-549.
[10] Nunes G,Barata AT,Santos CA,et al.Nutritional deficiency during colonoscopy preparation:the forgotten iatrogeny[J].Rev Esp Enferm Dig,2018,110(5):285-291.
[11] Dami?o R,Meneguci J,da Silva Santos á,et al.Nutritional risk and quality of life in community-dwelling elderly:a cross-sectional study[J].J Nutr Health Aging,2018,22(1):111-116.
[12] Baugreet S,Hamill RM,Kerry JP,et al.Mitigating nutrition and health deficiencies in older adults:a role for food innovation?[J].J Food Sci,2017,82(4):848-855.
[13] Cohen LB.Advances in bowel preparation for colonoscopy[J].Gastrointest Endosc Clin N Am,2015,25(2):183-197.
[14] Yao JF,Zhang W,Chen J,et al.Enteral nutrition before bowel preparation improves the safety of colonoscopy in the elderly[J].Turk J Gastroenterol,2013,24(5):400-405.