与时间相关的基准对监测结肠镜中的腺瘤检测率的影响:以STROBE陈述为导向的横截面队列研究
Tesshin Ban1, Yoshimasa Kubota2, Tomonori Yano3
1Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan; Division of Medicine, Deparment of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
概括
增加结肠镜观察时间,并确保退出时间超过输管时间,可以显著提高腺瘤检测率. 这种质量基准通过识别更多的前体病变,提高了结直肠癌的预防.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 预防癌症 预防癌症
背景情况:
- 结肠直肠腺瘤是结肠直肠癌的前体,这是一个日益严重的全球健康问题.
- 在结肠镜检查期间高腺瘤检测率 (ADR) 对于有效的癌症预防至关重要.
- 目前对结肠镜检查的质量指标需要改进,以优化腺瘤检测.
研究的目的:
- 为了评估分层结肠镜观察时间的临床影响.
- 评估观察时间/输入管时间比在腺瘤检测中的作用.
- 为结肠镜检查程序建立一个新的质量指标.
主要方法:
- 这是一项对369名接受结肠镜检查的患者的回顾性研究.
- 将结肠镜观察时间和观察时间/输入管时间比率分为四类.
- 用单变量和逻辑回归分析影响腺瘤检测率的因素.
主要成果:
- 在61.2%的患者中检测到腺瘤.
- 增加腺瘤检测的关键因素包括年龄≥53岁,酒精摄入量,以及特定的观察时间/输入时间比率类别 (≥6.0分钟和≥1.0).
- 后勤回归证实了年龄,酒精摄入量和更高的观察时间/输入时间比率类别作为腺瘤检测的重要预测因素.
结论:
- 建议将结合结肠镜观察时间 (>6分钟) 和观察时间/输入管时间比率 (>1) 的综合基准作为一种新的质量指标.
- 这一基准可以提高腺瘤检测率,有助于改善结直肠癌的预防.
- 这些发现为内镜医生提供了一个重要的教育信息,以优化结肠镜质量.
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