不完整的小肠囊内镜:实时查看的风险因素和成本效益
Matilde Topa1, Alessandro Rimondi2, Andrea Sorge1
1Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
小肠囊内镜 (SBCE) 中的实时查看 (RTV) 很少在不完整的程序中需要,因为长时间的胃排空是不常见的原因. 系统的RTV实施是昂贵的,并为提高SBCE完成率提供了不确定的好处.
科学领域:
- 胃肠病学 胃肠病学
- 医疗器械 医疗器械
- 诊断程序 诊断程序 诊断程序
背景情况:
- 国际指导方针主张在囊内镜检查期间进行实时查看 (RTV),以监测胃排空.
- 尽管有建议,但RTV在临床实践中经常未得到充分利用.
- 这项研究调查了小肠囊内镜 (SBCE) 中RTV的必要性和成本效益.
研究的目的:
- 识别与不完整的SBCE相关的风险因素.
- 评估实施RTV的临床相关性和成本效益.
主要方法:
- 分析了在2013年至2020年期间没有RTV进行的858次连续SBCE程序.
- 用于确定不完整SBCE的风险因素的多变量逻辑回归.
- 评估的关键因素包括延长的胃过境时间 (GTT) 和延长的小肠过境时间 (SBTT).
主要成果:
- 总体上,SBCE的完成率为94.6%.
- 长时间的GTT是不完整的SBCE的重要独立风险因素 (OR 2.9).
- 由于长时间的GTT导致的不完整的SBCE仅发生在0.7%的病例中,这表明发病率低.
结论:
- 现代囊内镜器件很少导致不完整的程序,长时间的胃排空是罕见的原因.
- 在这种低发病率的场景中,系统的RTV实施与大量成本 (€5059) 和不确定的有效性有关.
- 广泛使用RTV用于例行SBCE的临床实用性和成本效益需要仔细考虑.
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