作为结肠囊内镜疗法的有效性指标的后续内镜率:系统性审查和元分析
Ian Io Lei1,2, Alexandra Agache3,4, Alexander Robertson5
1Gastroenterology, University of Warwick, Coventry, UK Brian.lei@warwick.ac.uk.
结肠囊内镜 (CCE) 的高后续内镜率 (FER) 为0.42,影响了成本效益. 优化患者选择和肠道准备可以减少对下部肠道检查的重新检查需求.
科学领域:
- 胃肠病学 胃肠病学
- 医疗器械 医疗器械
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结肠囊内镜 (CCE) 提供了一种不那么侵入性的方法来调查下部胃肠道症状.
- 关于成本效益的担忧阻碍了CCE的采用,主要与随访内镜率 (FER) 相关.
- 了解FER对于将CCE纳入标准临床实践至关重要.
研究的目的:
- 综合现有证据,评估CCE后进一步调查的总体速度.
- 确定影响CCE程序后续内镜率的因素.
主要方法:
- 按照PRISMA指南进行了系统审查和元分析.
- 对Medline,Embase和PubMed的搜索进行到2024年8月15日.
- 分析了包括2850名参与者的19项研究,使用随机效应模型和元回归.
主要成果:
- 对于CCE的聚合FER为0.42 (95%CI为0.34-0.50),明显高于结肠镜 (0.10-0.15) 和CT结肠镜 (0.25).
- 完整的结肠过境和充分的肠道清洗与FER相反相关.
- CCE2囊显示了比CCE1更高的重新调查风险,可能是由于诊断准确度提高.
结论:
- CCE表现出相当大的FER,需要采取战略来减少重新调查.
- 适当的患者选择,改善肠道准备和优化囊指示对于提高成本效益和患者满意度至关重要.
- 未来的研究应该专注于提高CCE的完成率和肠道准备协议.
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