县域医共体模式下提高结直肠癌重点人群肠镜筛查依从率及早癌检出率的研究  

Study on improving the compliance rate of colonoscopy screening and the detection rate of early cancer in key population of colorectal cancer under county medical community model

作　　者：唐长菱 韩丹 王达[3] TANG Changling;HAN Dan;WANG Da(Department of Colorectal Surgery,Deqing County People's Hospital,Deqing 313200,China)

机构地区：[1]德清县人民医院肛肠外科,浙江德清313200 [2]德清县人民医院医务部,浙江德清313200 [3]浙江大学医学院附属邵逸夫医院肛肠外科

出　　处：《全科医学临床与教育》2024年第4期354-356,363,共4页Clinical Education of General Practice

基　　金：浙江省湖州市科技局2021年度市级科技计划医卫一般项目(2021GY4)。

摘　　要：目的研究县域医共体模式下结直肠癌重点人群肠镜筛查依从率及早癌检出率情况。方法选取2020~2022年德清县大肠癌筛查民生项目中大肠癌初筛阳性8549例,依据随机数字表法分为实验组(采用“最多跑一次”结直肠癌流程)和对照组(采用正常预约肠镜流程)。比较两组其肠镜检查依从性和早癌检出率。结果实验组2020~2022年结肠镜依从率分别为64.55%、54.36%、64.65%,明显高于对照组的46.19%、37.08%、34.21%,差异均有统计学意义(χ^(2)分别=61.51、47.45、132.38,P均<0.05)。实验组2020~2022年早癌检出率分别为7.65%、8.05%、8.05%,明显高于对照组的5.10%、4.63%、3.74%,差异均有统计学意义(χ^(2)分别=5.74、9.17、14.36,P均<0.05)。结论通过发挥发展同质错位、资源统一调配、数据共享互通、上下贯通的医共体优势,在大肠癌筛查中设计出“最多跑一次”结直肠癌筛查流程,能够显著提高阳性人群的肠镜依从性,从而提高了早癌的检出率。Objective To study the compliance rate of colonoscopy screening and early cancer detection rate of colorectal cancer key population under the county medical community model.Methods A total of 8,549 cases of positive colorectal cancer screening in the 2020-2022 Deqing County Colorectal Cancer Screening and Livelihood Program were selected and divided into the experimental group(adopting the"one-stop-shopping"colorectal cancer process)and the control group(adopting the normal booking process for colonoscopy)based on the randomized numerical table method.The colonoscopy compliance and early cancer screening rate were compared between the two groups.Results The colonoscopy compliance rates of the experimental group in 2020-2022 were 64.55%,54.36%,and 64.65%,which were significantly higher than those of the control group(46.19%,37.08%,and 34.21%),and the differences were statistically significant(χ^(2)=61.51,47.45,132.38,P<0.05).The detection rate of early cancer from 2020 to 2022 in the experimental group was 7.65%,8.05%,and 8.05%,which was significantly higher than that in the control group,which was 5.10%,4.63%,and 3.74%,and the differences were statistically significant(χ^(2)=5.74,9.17,14.36,P<0.05).Conclusion By taking advantage of the medical community's advantages of homogeneous mismatch,unified deployment of resources,data sharing and communication,and upward and downward communication,the design of the"one-stop-shopping"colorectal cancer screening process in colorectal cancer screening can significantly improve the colonoscopy adherence rate of the positive population,and thus increase the detection rate of early-stage cancer.

关 键 词：医共体 结直肠癌 肠镜依从性 早癌检出率 

分 类 号：R735.34[医药卫生—肿瘤]