在日本,结肠镜检查和食管-胃管-肠膜检查之间的并发症差异,使用大规模的医疗保险索赔数据
Naohisa Yoshida1, Hideki Ishikawa2, Michihro Mutoh2
1Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
结肠镜检查 (CS) 的穿孔率高于食管胃管腺镜检查 (EGD),但出血率相似. 这项大规模分析比较了这些内镜手术之间的严重并发症.
科学领域:
- 胃肠病学 胃肠病学
- 医疗数据分析 医学数据分析
- 公共卫生 公共卫生
背景情况:
- 肠镜检查,如结肠镜检查 (CS) 和食管胃肠镜检查 (EGD),对于胃肠健康至关重要.
- 了解严重并发症率对于优化内镜实践和患者安全至关重要.
研究的目的:
- 为了比较CS和EGD之间严重并发症的发生率,包括出血,穿孔和致命事件.
- 在大量患者队列中确定与这些并发症相关的风险因素.
主要方法:
- 对超过300万患者的匿名医疗保险索赔数据的回顾性分析 (2010年1月 - 2020年12月).
- 纳入标准:50岁及以上的患者在没有治疗干预的情况下接受CS或EGD.
- 在CS和EGD组之间比较并发症率和风险因素.
主要成果:
- 虽然出血和致命事件的发生率相似,但CS的穿孔率明显高 (0.0024%) 比EGD (0.0006%).
- 随着活检和抗血栓使用,出血风险增加. 年轻患者 (50-64岁) 和男性的穿孔风险更高.
- 脑脊髓病的并发症率与患者年龄没有显著变化.
结论:
- 结肠镜检查 (CS) 与食管胃管腺镜检查 (EGD) 相比,与穿孔的风险更高有关.
- 在这两种手术中,出血并发症的发生率相似.
- 没有发现年龄是影响CS并发症发生率的重要因素.
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