“南海模式”早期胃癌筛查策略在基层社区中的应用评价  

Evaluation on the application of″Nanhai Model″early gastric cancer screening strategy in grass-roots communities

作　　者：陈羽[1] 黄俊[1] 薛兰凤 孙占军 赵爱民 白杨[2] 智发朝[2] 杜庆锋[1] CHEN Yu;HUANG Jun;XUE Lan-feng;SUN Zhan-jun;ZHAO Ai-min;BAI Yang;ZHI Fa-chao;DU Qing-feng(Department of Gastroenterology,The Seventh Affiliated Hospital of Southern Medical University,Foshan,Guangdong 528244;Department of Gastroenterology,NANFANG Hospital of Southern Medical University,Guangzhou,Guangdong 510080)

机构地区：[1]南方医科大学第七附属医院消化内科,1528244 [2]南方医科大学南方医院消化内科,2510080

出　　处：《现代消化及介入诊疗》2021年第8期939-943,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：佛山市卫生健康局医学科研课题(20220809A010002,20220809A010452)。

摘　　要：目的基于全科医学+医共体的"南海模式"早期胃癌筛查策略在基层社区无症状人群应用过程的实施研究。方法通过全科医学+医共体构建"南海模式"早期胃癌筛查策略,统计2019年1月至2019年12月在佛山市南海区里水镇早期胃癌筛查的实施研究中的相应数据;纵向对比本地区在开展胃癌筛查工作前后的内镜应答率及早癌检出率,并对早期胃癌比例、胃功能水平和危险分层以及住院费用等进行分析。结果南海地区胃癌风险评分分层中危组(0.91%)、高危组(1.69%)胃癌的组内占比明显高于低危组(0.30%);地区里胃癌病例的胃功能评分对比非胃癌病例具有显著差异(P<0.001);2019年下半年内镜应答率较2019年上半年提高(21.2%vs 16.6%,P<0.001);胃癌检出率呈现线性上升趋势;早期胃癌患者住院治疗总费用明显低于中晚期胃癌患者(P<0.05)。结论"南海模式"对于基层社区的早期胃癌筛查具有一定优势,特别是在提高内镜应答率等方面。Objective To explore the application of″Nanhai Model″screening strategy for early gastric cancer in a symptomatic population in grass-roots community based on general practice and medical community.Methods The screening strategy of″Nanhai Model″for early gastric cancer was constructed through general practice and medical community,and the corresponding data of early gastric cancer screening in Lishui Town,Nanhai District,Foshan City from January 2019 to December 2019 were collected.The endoscopic response rate and early cancer detection rate were longitudinally compared,and the proportion of early gastric cancer,gastric function level,risk stratification and hospitalization costs were analyzed.Results The proportion of gastric cancer in the middle-risk group(0.91%)and high-risk group(1.69%)was significantly higher than that in the low-risk group(0.30%).The gastric function score of gastric cancer cases in the region was significantly higher than that of non-gastric cancer cases(P<0.001).The endoscopic response rate in the second half of 2019 was higher than that in the first half of 2019(21.2%vs 16.6%P<0.001).The detection rate of gastric cancer showed a linear upward trend,and the total cost of hospitalization for patients with early gastric cancer is significantly lower than that for patients with advanced gastric cancer(P<0.05).Conclusion The″Nanhai Model″has certain advantages for the screening of early gastric cancer in the grass-roots community,especially in improving the endoscopic response rate.

关 键 词：胃癌筛查 胃功能 检出率 基层社区 全科医生 

分 类 号：R573.9[医药卫生—消化系统]