基于与准备相关的预测模型的个性化干预改善了肠道准备的充分性:一个前性的,多中心的,随机的,受控的研究
Long Chen1, Xiaoyu Kang1, Gui Ren1
1State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
概括
使用与准备相关的模型 (PRM) 进行的个性化干预显著改善了结肠镜检查的肠道准备 (BP) 质量. 这种方法也增加了高风险患者的腺瘤检测率 (ADR).
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 临床试验研究 临床试验研究
背景情况:
- 肠道准备不足 (BP) 是结肠镜检查中的一个常见挑战.
- 之前的研究开发了一个与准备相关的模型 (PRM) 来预测不充分的BP.
- 基于PRM的个性化干预措施对改善BP充足性的有效性尚未确定.
研究的目的:
- 调查基于PRM的个性化干预是否可以提高肠道准备的质量.
- 评估这项干预措施对腺瘤检测率 (ADR) 和患者安全的影响.
主要方法:
- 进行了一项前性随机对照试验,其中900名患者接受了早晨结肠镜检查.
- 患者被随机分配到个性化组或标准组.
- 在个性化组中的高风险患者 (PRM评分≥3) 获得了额外的1.5升聚乙烯糖醇 (PEG),而标准组没有.
主要成果:
- 与标准组 (84.7%,p=0.001) 相比,个性化干预组的足够血压率 (91.8%) 显著高于标准组 (84.7%,p=0.001).
- 在高风险患者中,个性化组 (94.3%) 与标准组 (49.3%,p<0.001) 相比,适当的血压率显著改善.
- 与标准组 (16.9%,p<0.001) 相比,接受个性化干预的高风险患者 (40.9%) 的腺瘤检测率 (ADR) 显著高于标准组 (16.9%,p<0.001).
结论:
- 由PRM指导的个性化干预,包括高风险患者的额外PEG剂量,有效地改善了肠道准备的质量.
- 这一策略在接受结肠镜检查的高风险个体中显著提高了ADR.
- 这项干预措施显示出良好的安全性,但并没有显著增加不良事件.
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