数字很重要:儿童内镜的质量如何随着每年的手术量而变化
Jeannie S Huang1,2,3, Lillian Choi1,2, Tom K Lin1,2
1Department of Pediatrics, University of California San Diego, La Jolla, California, USA.
Journal of pediatric gastroenterology and nutrition
|October 3, 2025
概括
儿科内镜的质量随着每年更高的手术量 (APV) 和更多年的经验而提高. 每年至少进行40次胆管结肠镜检查与获得高质量的儿科内镜手术有关.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 提高内镜质量的改善
- 医疗保健研究成果 研究成果
背景情况:
- 关于儿科内镜医生经验与程序质量之间的联系的数据有限.
- 评估教师医生的实践年数和年度程序量 (APV) 对儿科内镜质量的影响至关重要.
研究的目的:
- 调查教师内镜师经验 (实践年数,APV) 和儿科内镜的关键质量指标之间的关联.
- 为了确定特定的经验值是否预测了改善的程序结果,包括终端内输管率 (TIIR) 和内输管率 (CIR).
主要方法:
- 儿科三级医疗学术机构的教师内镜师进行的乳头结肠镜的回顾性分析 (2021年10月 - 2024年5月).
- 由儿科内镜质量改善网络 (PEnQuIN) 定义的质量指标被提取.
- 统计分析包括Kruskal-Wallis,多变量建模和比例危险建模,以评估经验和APV对TIIR,CIR和程序持续时间的影响.
主要成果:
- 总共分析了985次胆结肠镜检查,由20名教师内镜师进行,经验水平不同,APV中位数为19.
- 每年≥40次大肠直肠镜的APV是实现≥85%的TIIR (p<0.01) 的重要预测因素.
- 经验更丰富的教师 (≥10年) 与经验低于10年的教师相比,程序持续时间显著缩短.
结论:
- 儿科内镜质量指标与个体内镜师的APV和多年的经验有很大关系.
- 达到每年≥40次大肠直肠镜的APV可能是确保儿科患者高质量的内镜手术的基准.
- 这些发现强调了经验和程序量在维持儿科内镜质量标准方面的重要性.
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