辽宁省农村医疗机构上消化道癌早诊早治筛查能力评估  

Evaluation of the Capacity in Screening,Early Diagnosis and Treatment of Upper Gastrointestinal Cancer in Rural Medical Institutions of Liaoning Province

作　　者：佟爽[1] 阎佳宁 尚德高[1] 秦怡[1] 孙笠翔[1] 于连政[1] TONG Shuang;YAN Jia-ning;SHANG De-gao;QIN Yi;SUN Li-xiang;YU Lian-zheng(Liaoning Center for Disease Control and Prevention,Shenyang 110005,China)

机构地区：[1]辽宁省疾病预防控制中心,辽宁沈阳110005

出　　处：《中国肿瘤》2021年第12期890-894,共5页China Cancer

基　　金：国家重点研发计划项目(2018YFC1311600);中国消化道癌医师共同成长计划(GTCZ-2020-LN-21-0002);辽宁省科学技术计划(2019-ZD-1086)。

摘　　要：[目的]评估辽宁省农村地区二级以上医疗机构上消化道癌早诊早治筛查能力及开展机会性筛查的效果。[方法]从硬件能力、诊疗水平、辅助技术、人员能力方面比较2015—2017年和2018—2020年辽宁省开展机会性筛查项目医院和非项目医院之间的筛查能力差异。[结果]辽宁省11个地市的59家医疗机构参与调查,其中项目医院11家(18.64%),非项目医院48家(81.36%)。项目医院从硬件能力(内镜中心、病理中心、内镜数量)、诊疗水平[年均胃镜操作数量、病理诊断数量、内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)与内镜黏膜切除术(endoscopic mucosal resection,EMR)技术开展情况]、辅助技术(碘染色开展情况)、人员能力(内镜、病理专业人员数量)方面均显著高于非项目医院(P<0.05);但无论是项目医院还是非项目医院均存在活检率、ESD/EMR开展数量、碘染色开展比例整体偏低的问题。[结论]机会性筛查项目促进了辽宁省上消化道癌筛查能力的全面提升,但仍存在不足。上消化道癌筛查能力的评估除了传统的评估指标,还可以从硬件能力、诊疗水平、辅助技术和人员能力着手开展评估。[Purpose]To evaluate the capacity in screening,early diagnosis and treatment of upper gastrointestinal cancer in secondary health institutions in rural areas of Liaoning Province.[Methods]The capacity of screening,early diagnosis and treatment between the hospitals carrying out the opportunistic screening project(project hospitals)and the non-project hospitals in rural areas of Liaoning Province from 2015—2017 and 2018—2020 were compared in terms of facilities,diagnosis and treatment level,auxiliary techniques,and personnel ability.[Results]There were 59 medical institutions in 11 districts of Liaoning Province participated in the survey,including 11(18.64%)project hospitals and 48(81.36%)non-project hospitals.The project hospitals were significantly more advanced than the non-project hospitals in terms of hardware capacity(endoscopy center,pathology center,number of endoscopies),diagnosis and treatment level[annual average number of gastroscopic operations,number of pathological diagnosis,endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)technique development],ancillary technique(iodine staining),personnel capability(number of endoscopy and pathology professionals)(P<0.05).However,the overall low rates of biopsy,ESD/EMR procedures,and iodine staining rate were common problems in both project and non-project hospitals.[Conclusion]The opportunistic screening project has promoted the comprehensive development of upper gastrointestinal cancer screening ability in Liaoning Province,but there are still deficiencies.The evaluation of upper gastrointestinal cancer screening capabilities can more comprehensively assess the facility development,diagnosis and treatment levels,ancillary techniques,and personnel capabilities.

关 键 词：筛查能力 上消化道癌 机会性筛查 评估 农村 辽宁 

分 类 号：R73-31[医药卫生—肿瘤]