门诊患者结直肠癌肠镜筛查依从性的相关影响因素研究  

Influencing factors for colonoscopic compliance to colorectal cancer screening in outpatients

作　　者：谭雪娇 彭昕[1] 秦健[2] 李加学 冶丽娜 濮蓉晖[5] 赖力 马家静 陈卫刚[1] Tan Xuejiao;Peng Xin;Qin Jian;Li Jiaxue;Ye Lina;Pu Ronghui;Lai Li;Ma Jiajing;Chen Weigang(Department of Gastroenterology,The First Affiliated Hospital of Shihezi University,Shihezi 832000,China;Department of Gastroenterology,The Fourth Division Hospital of Xinjiang Production and Construction Corps,Yili 835000,China;Department of Gastroenterology and Oncology,The Third Division Hospital(Kashgar Hospital)of Xinjiang Production and Construction Corps,Kashgar 844000,China;Department of Gastroenterology,Xinjiang Production and Construction Corps 13th Division Red Star Hospital,Hami 839000,China;Department of Gastroenterology,Xinjiang Production and Construction Corps 10th Division Beitun Hospital,Beitun 836099,China;Department of Gastroenterology,The Seventh Division Hospital of Xinjiang Production and Construction Corps,Kuitun 833200,China;Department of Gastroenterology,The Fifth Division Hospital of Xinjiang Production and Construction Corps,Bole 833400,China)

机构地区：[1]石河子大学第一附属医院消化内科,石河子832000 [2]新疆生产建设兵团第四师医院消化内科,伊犁835000 [3]新疆生产建设兵团第三师医院(喀什院区)消化肿瘤科,喀什844000 [4]新疆生产建设兵团第十三师红星医院消化内科,哈密839000 [5]新疆生产建设兵团第十师北屯医院消化科,北屯836099 [6]新疆生产建设兵团第七师医院消化科,奎屯833200 [7]新疆生产建设兵团第五师医院消化内科,博乐833400

出　　处：《中华消化内镜杂志》2024年第2期131-136,共6页Chinese Journal of Digestive Endoscopy

基　　金：兵团财政科技计划项目(2020CB002);石河子大学成果转化与技术推广计划项目(CGZH201704);中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2020-PT330-003)。

摘　　要：目的探讨影响门诊患者结直肠癌肠镜筛查依从性的独立危险因素。方法纳入2022年1月至2022年6月在新疆7个地州内7家三级医院消化内科门诊就诊的40~74岁患者,结合患者就诊情况对符合肠镜检查条件的患者提出筛查建议,并通过问卷收集信息。先采用χ^(2)检验比较依从与未依从肠镜筛查建议患者的特征差异,再采用多因素logistic回归模型(逐步回归:向前,有条件)分析与结肠镜筛查依从性相关的独立危险因素。结果从7个中心共获取463份有效问卷,依从肠镜检查建议者427例(92.2%)、未依从肠镜检查建议者36例(7.8%)。χ^(2)检验发现,两类人群在性别构成、年龄分布、文化程度构成、肠息肉主观认知构成、有无结直肠息肉个人史、有无结直肠癌家族史、有无结直肠息肉家族史、有无腹痛或腹胀症状以及有无大便习惯或性状改变方面差异均有统计学意义(P<0.05)。多因素logistic回归分析发现,40~49岁人群(P=0.005,OR=0.141,95%CI:0.036~0.549)、50~59岁人群(P=0.039,OR=0.257,95%CI:0.071~0.932)肠镜检查依从性均明显差于60~74岁人群;中学文化程度人群(P=0.011,OR=3.121,95%CI:1.304~7.473)、本专科及以上文化程度人群(P=0.016,OR=3.544,95%CI:1.270~9.890)肠镜检查依从性均明显好于小学及以下文化程度人群;有结直肠息肉个人史人群肠镜检查依从性明显好于无结直肠息肉个人史人群(P=0.015,OR=12.288,95%CI:1.629~92.719);有结直肠癌家族史人群肠镜检查依从性明显好于无结直肠癌家族史人群(P=0.038,OR=8.506,95%CI:1.124~64.351);有大便习惯或性状改变人群肠镜检查依从性明显好于无大便习惯或性状改变人群(P=0.039,OR=4.794,95%CI:1.085~21.192)。结论新疆7个地州内7家三级医院门诊患者肠镜筛查依从性与患者年龄、文化程度、结直肠息肉个人史、直肠癌家族史以及大便习惯或性状改变密切相关。年龄在40~59岁、文化程度较低、既往无息�ObjectiveTo explore the influencing factors for compliance to colonoscopy screening for colorectal cancer in outpatients.MethodsPatients aged 40-74 years who visited the outpatient gastroenterology department of 7 tertiary hospitals in 7 regions of Xinjiang from January 2022 to June 2022 were enrolled.Recommendations for colonoscopy screening were made according to the patient's medical conditions,and the questionnaire was used to collect information.The Chi-square test was used to compare the differences of compliant and non-compliant patients.Multivariate logistic regression was used to analyze the influencing factors of compliance to colonoscopy screening.ResultsA total of 463 valid questionnaires were obtained from 7 centers,in which,427 outpatients(92.2%)followed the recommendation for colonoscopy screening,and 36(7.8%)did not.Chi-square test results showed that there were statistically significant differences between the two groups in gender,age,education,subjective cognition of intestinal polyps,personal history of colorectal polyps,family history of colorectal cancer,family history of colorectal polyps,abdominal pain or distension,and defecation habit or stool changes(P<0.05).The results of multivariate regression analysis showed that the screening compliance of patients aged 40-49 years(P=0.005,OR=0.141,95%CI:0.036-0.549)and 50-59 years(P=0.039,OR=0.257,95%CI:0.071-0.932)was lower than that of patients aged 60-74 years.The screening compliance of patients with high school education(P=0.011,OR=3.121,95%CI:1.304-7.473)and college education or above(P=0.016,OR=3.544,95%CI:1.270-9.890)was higher than those with primary school education and below.Patients with personal history of colorectal polyps(P=0.015,OR=12.288,95%CI:1.629-92.719),family history of colorectal cancer(P=0.038,OR=8.506,95%CI:1.124-64.351)and changes in defecation habit or stool trait(P=0.039,OR=4.794,95%CI:1.085-21.192)also had higher compliance.ConclusionAge,educational level,personal history of colorectal polyps,and family history of color

关 键 词：结肠镜检查 结直肠癌 门诊患者 依从性 影响因素 

分 类 号：R735.34[医药卫生—肿瘤]