结直肠平坦型腺瘤肠镜检出的可控影响因素分析  

Analysis of controllable factors influencing detection rate of colorectal flat adenomas detected by colonoscopy

作　　者：袁小刚[1] 薛净 项立[3] 杨兵[3] 林建姣[1] 周永柏[3] 龙子义[3] 陈晓红[1] 黄妙娟[1] 胡红松[1] YUAN Xiao-gang;XUE Jing;XIANG Li;YANG Bing;LIN Jian-jiao;ZHOU Yong-bo;LONG Zi-yi;CHENG Xiao-hong;HUANG Miao-juan;HU Hong-song(Department of Gastroenterology,Longgang District People's Hospital of Shenzhen,Shenzhen Digestive Disease Center of Nanfang Hospital,Southern Medical University,Shenzhen518172,Guangdong Province,China;Armed Police Beijing General Hospital,Beijing100027,China;Department of Gastroenterology,Longgang Central Hospital of Shenzhen518116,Guangdong Province,China)

机构地区：[1]广东省深圳市龙岗区人民医院消化内科(南方医科大学南方医院深圳消化病诊疗中心),518172 [2]武警北京总医院,100027 [3]广东省深圳市龙岗中心医院消化内科,518116

出　　处：《现代消化及介入诊疗》2017年第5期631-634,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：深圳市科技计划项目(JCYJ20150403091931199);深圳市龙岗区科技发展资金医疗卫生项目(YLWS20150513174059684)

摘　　要：目的探讨结直肠平坦型腺瘤肠镜检出率(flat adenoma detection rate,FADR)的可控影响因素,以提高结肠镜检查质量。方法回顾性分析2 986例患者的临床内镜资料,按肠道清洁度及内镜操作医师的特征(包括操作例数、专业背景、操作方式及退镜时间)计算出FADR,再比较各组FADR的差异,对差异有统计学意义的影响因素进行Logistic回归分析。结果单因素分析显示肠道清洁度、操作例数、操作方式及退镜时间对FADR有显著影响(P<0.01),而操作医师的专业背景对FADR的影响无统计学意义(P>0.05);多因素分析结果显示肠道清洁度、操作例数、操作方式及退镜时间是FADR的独立影响因素。结论在良好的肠道准备条件下,操作医生累积结肠镜操作1 000例以上,采用单人操作法,保证退镜时间在6 min以上可显著提高FADR,从而有效提高结肠镜检查质量。Objective To investigate the controllable factors influencing colorectal flat adenomas detectionrate(FADR).Methods We retrospectively analyzed the clinical data of2,986cases of patients who underwent colonoscopy at two participating hospitals between August2015and December2016.FADR was calculated in different bowel cleanliness and the features of endoscopists(including the number of operations,professional background,operation mode and withdrawal time).Then the differences between the two groups were analyzed.Multivariate logistic regression analysis was used to analyze factors with statistical significance.Results Univariate analysis showed that the bowel cleanliness,professional background of colonoscopists,operation mode and withdrawal time were significantly associated with FADR(P<0.01),while the specialty of colonoscopists was not(P>0.05).Multivariate analysis revealed that the bowel cleanliness,the number of operation cases,mode of operation and time of withdrawal were independent influencing factors of FADR.Conclusion In good bowel preparation conditions,colonoscopists who accumulated colonoscopy for more than1,000cases,adopted the one-person technique,and ensured the withdrawal time over6minuets could improve FADR,thus might effectively improve the quality of colonoscopy

关 键 词：结肠镜 影响因素 平坦型腺瘤 息肉 腺瘤检出率 

分 类 号：R735.34[医药卫生—肿瘤]