北京市三级医院小肠疾病诊治现状

发布时间：2018-09-19 13:35

【摘要】：目的调查北京市三级医院小肠疾病诊治现状以及小肠内镜使用情况。方法采用网络问卷调查北京市29家三级医院小肠疾病诊治设备的装备情况、胶囊内镜和气囊电子小肠镜应用、指南掌握和参加继续教育情况、不明原因消化道出血(obscure gastrointestinal bleeding,OGIB)诊治流程等。结果北京市29家三级医院中,24家(82.8%)配备胶囊内镜,12家(41.4%)配备了气囊电子小肠镜,中位装备时间5~6年。胶囊内镜中位年诊治例数50~100例,无效检查率达1%~3%;气囊电子小肠镜中位年诊治例数小于50例,无效检查率达3%~5%;两种小肠内镜严重合并症发生率1%,整体阳性率50%~60%。各胶囊内镜阳性率与该院年诊治例数呈正相关(r=0.542,P=0.005)。仅有半数受访者掌握小肠疾病诊治指南,20.7%受访者从未参加相关继续教育项目。受访医生是否从事小肠内镜相关工作影响对首诊阴性OGIB病人的进一步诊治策略(χ2=3.898,P=0.048)。结论北京市三级医院胶囊内镜普及率高于气囊电子小肠镜,两者安全性较高,整体阳性率50%~60%。医生对指南规范掌握不足,需要加强继续教育,OGIB诊治流程有待进一步规范。
[Abstract]:Objective to investigate the status of diagnosis and treatment of small bowel diseases and the use of small bowel endoscopy in third-level hospitals in Beijing. Methods the equipment for diagnosis and treatment of small bowel diseases, the application of capsule endoscopy and balloon electronic enteroscopy, the guide to continue education and the status of continuous education were investigated by network questionnaire in 29 tertiary hospitals in Beijing. Process of diagnosis and treatment of unknown gastrointestinal hemorrhage (obscure gastrointestinal bleeding,OGIB). Results 24 (82.8%) of 29 third-level hospitals in Beijing were equipped with capsule endoscopy, 12 (41.4%) were equipped with balloon electronic enteroscopy, the median equipment time was 5 ~ 6 years. The median annual diagnosis and treatment of capsule endoscopy was 50 and 100 cases, the rate of ineffective examination was 1 and 3, the median number of cases was less than 50 cases and the rate of invalid examination was 3. 5%, the incidence of serious complications of two kinds of endoscopy was 1, and the positive rate was 50. 60%. The positive rate of endoscopy in each capsule was positively correlated with the number of cases diagnosed and treated in our hospital (r = 0.542P = 0.005). Only half of the respondents had a guide to the diagnosis and treatment of small bowel diseases. 20.7 percent of the respondents had never participated in relevant continuing education programs. Whether or not the doctor was engaged in enteroscopy-related work influenced the strategy of further diagnosis and treatment of first-diagnosed negative OGIB patients (蠂 2 3.898 P0. 048). Conclusion the prevalence rate of capsule endoscopy in the third class hospital of Beijing is higher than that of balloon electronic enteroscopy, the safety of both is higher, and the overall positive rate of capsule endoscopy is 50 and 60. Doctors do not have enough knowledge of the guidelines, and the OGIB diagnosis and treatment process needs to be further standardized.
【作者单位】：解放军总医院消化科;解放军总医院海南分院消化科;
【基金】：国家科技支撑计划课题(2015BAI13B07) 全军医学科技“十二五”科研项目(BWS13C028)~~
【分类号】：R574.5

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