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目的探讨氢气呼气试验在预测结肠镜检查肠道准备质量中的临床价值。方法84例结肠镜检查的患者分次口服90ml磷酸钠盐溶液进行肠道准备,在第2次口服磷酸钠盐溶液时摄入10g菊粉。在预约结肠镜检查时和结肠镜检查前5min分别采集患者呼出气体样本,测定氢气浓度;使用波士顿肠道准备评分量表(BBPS)评定肠道准备质量。结果根据肠道准备质量将患者分为合格组(65例)与不合格组(19例)。合格组BBPS总评分高于不合格组[(7.26±0.91)分vs.(4.63±0.76)分](P<0.01)。两组基础氢气浓度相似[(6.46±2.38)ppm vs.(6.37±2.69)ppm](P>0.05);肠道准备完成后,合格组氢气浓度低于不合格组[(3.54±1.74)ppm vs.(8.26±2.35)ppm](P<0.01)。ROC曲线显示,氢气浓度为4.5ppm时可以作为判断肠道准备质量的最佳临界值,其预测肠道准备质量的灵敏度和特异度分别为89.5%和80.0%。结论氢气呼气试验可以作为一个简单、可靠的非侵入性方法来预测肠道准备质量。
Objective To investigate the clinical value of hydrogen breath test in predicting the quality of colon preparation for colonoscopy. Methods Eighty-four patients undergoing colonoscopy were given oral gavage with 90 ml sodium phosphate salt solution and 10 g inulin in the second oral sodium phosphate solution. Samples of exhaled breath were collected at the time of booking a colonoscopy and at 5 minutes before colonoscopy to determine the concentration of hydrogen gas. The quality of intestinal preparation was evaluated by using the Boston Bowel Preparation Scale (BBPS). Results The patients were divided into the qualified group (65 cases) and the unqualified group (19 cases) according to the intestinal preparation quality. The score of BBPS in qualified group was higher than that of unqualified group [(7.26 ± 0.91) vs (4.63 ± 0.76) points] (P <0.01). The baseline hydrogen concentration was similar in both groups ([6.46 ± 2.38] ppm vs. (6.37 ± 2.69) ppm] (P> 0.05). After the intestine was prepared, the hydrogen concentration in the qualified group was lower than that in the unqualified group [(3.54 ± 1.74) ppm vs. (8.26 ± 2.35) ppm] (P <0.01). The ROC curve showed that the hydrogen concentration of 4.5ppm can be used as the best cutoff value to judge the quality of intestinal preparation. The sensitivity and specificity of predicting intestinal preparation quality are 89.5% and 80.0% respectively. Conclusion Hydrogen breath test can be used as a simple, reliable and noninvasive method to predict the quality of intestinal preparation.