引入跨鼻腔内镜对扩大诊断内镜服务的影响
Ben Thomas Crosby1, Laura Munglani2, Karen Wright3
1Velindre Cancer Centre, Cardiff, UK.
BMJ open quality
|January 30, 2025
概括
透鼻内镜 (TNE) 是对透口内镜 (TOE) 的一个有希望的替代方案,提供更好的患者耐受性和优越的诊断性能. 这项研究发现,TNE更便宜,更高效,在关键性能指标和图像质量方面优于TOE.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术是一种内镜手术.
- 诊断成像诊断成像的使用
背景情况:
- 英国对内镜服务的日益增长的需求超过了目前的产能.
- 透鼻内镜 (TNE) 提供了比透口内镜 (TOE) 更好的患者舒适性,因为范围更窄,反射减少.
- 与TOE相比,TNE的诊断准确性,成本效益和效率仍然存在不确定性.
研究的目的:
- 评估TNE在应对不断增长的内镜需求方面的实用性.
- 在诊断结果,程序成本和部门时间方面,比较TNE与标准TOE.
- 评估TNE程序的质量,包括性能指标和图像清晰度.
主要方法:
- 一项比较研究评估了100个TNE程序与141个匹配的TOE程序.
- 收集的数据包括程序成功率,持续时间,部门时间和成本效益.
- 使用POLPREP评分评估图像质量,并将诊断性能与已建立的关键绩效指标进行基准测试.
主要成果:
- 在关键绩效指标 (逆向曲,十二指管内置) 中,TNE的成功率达到了95%以上,超过了TOE (p=0.026).
- TNE显示出优异的食道图像质量 (POLPREP A3得分,p=0.028) 并与胃和十二指肠的TOE相似.
- TNE成功地管理了TOE以前失败的复杂病例 (91.7%的成功率),并显示了诊断巴雷特食道的潜力 (39%对TOE的14.8%).
结论:
- 透鼻内镜 (TNE) 是大多数诊断性胃肠道评估的可行和有前途的跨口内镜 (TOE) 的替代方案.
- 与TOE相比,TNE更具成本效益,患者更好地容忍,并在多个关键领域表现出优越的性能.
- 这些发现支持在现代医疗保健服务中更广泛地采用TNE,以管理内镜需求并改善患者的治疗结果.
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