【摘要】：目的調(diào)查北京市三級(jí)醫(yī)院小腸疾病診治現(xiàn)狀以及小腸內(nèi)鏡使用情況。方法采用網(wǎng)絡(luò)問卷調(diào)查北京市29家三級(jí)醫(yī)院小腸疾病診治設(shè)備的裝備情況、膠囊內(nèi)鏡和氣囊電子小腸鏡應(yīng)用、指南掌握和參加繼續(xù)教育情況、不明原因消化道出血(obscure gastrointestinal bleeding,OGIB)診治流程等。結(jié)果北京市29家三級(jí)醫(yī)院中,24家(82.8%)配備膠囊內(nèi)鏡,12家(41.4%)配備了氣囊電子小腸鏡,中位裝備時(shí)間5~6年。膠囊內(nèi)鏡中位年診治例數(shù)50~100例,無效檢查率達(dá)1%~3%;氣囊電子小腸鏡中位年診治例數(shù)小于50例,無效檢查率達(dá)3%~5%;兩種小腸內(nèi)鏡嚴(yán)重合并癥發(fā)生率1%,整體陽性率50%~60%。各膠囊內(nèi)鏡陽性率與該院年診治例數(shù)呈正相關(guān)(r=0.542,P=0.005)。僅有半數(shù)受訪者掌握小腸疾病診治指南,20.7%受訪者從未參加相關(guān)繼續(xù)教育項(xiàng)目。受訪醫(yī)生是否從事小腸內(nèi)鏡相關(guān)工作影響對(duì)首診陰性O(shè)GIB病人的進(jìn)一步診治策略(χ2=3.898,P=0.048)。結(jié)論北京市三級(jí)醫(yī)院膠囊內(nèi)鏡普及率高于氣囊電子小腸鏡,兩者安全性較高,整體陽性率50%~60%。醫(yī)生對(duì)指南規(guī)范掌握不足,需要加強(qiáng)繼續(xù)教育,OGIB診治流程有待進(jìn)一步規(guī)范。
[Abstract]:Objective to investigate the status of diagnosis and treatment of small bowel diseases and the use of small bowel endoscopy in third-level hospitals in Beijing. Methods the equipment for diagnosis and treatment of small bowel diseases, the application of capsule endoscopy and balloon electronic enteroscopy, the guide to continue education and the status of continuous education were investigated by network questionnaire in 29 tertiary hospitals in Beijing. Process of diagnosis and treatment of unknown gastrointestinal hemorrhage (obscure gastrointestinal bleeding,OGIB). Results 24 (82.8%) of 29 third-level hospitals in Beijing were equipped with capsule endoscopy, 12 (41.4%) were equipped with balloon electronic enteroscopy, the median equipment time was 5 ~ 6 years. The median annual diagnosis and treatment of capsule endoscopy was 50 and 100 cases, the rate of ineffective examination was 1 and 3, the median number of cases was less than 50 cases and the rate of invalid examination was 3. 5%, the incidence of serious complications of two kinds of endoscopy was 1, and the positive rate was 50. 60%. The positive rate of endoscopy in each capsule was positively correlated with the number of cases diagnosed and treated in our hospital (r = 0.542P = 0.005). Only half of the respondents had a guide to the diagnosis and treatment of small bowel diseases. 20.7 percent of the respondents had never participated in relevant continuing education programs. Whether or not the doctor was engaged in enteroscopy-related work influenced the strategy of further diagnosis and treatment of first-diagnosed negative OGIB patients (蠂 2 3.898 P0. 048). Conclusion the prevalence rate of capsule endoscopy in the third class hospital of Beijing is higher than that of balloon electronic enteroscopy, the safety of both is higher, and the overall positive rate of capsule endoscopy is 50 and 60. Doctors do not have enough knowledge of the guidelines, and the OGIB diagnosis and treatment process needs to be further standardized.
【作者單位】： 解放軍總醫(yī)院消化科;解放軍總醫(yī)院海南分院消化科;
【基金】：國(guó)家科技支撐計(jì)劃課題(2015BAI13B07) 全軍醫(yī)學(xué)科技“十二五”科研項(xiàng)目(BWS13C028)~~
【分類號(hào)】：R574.5

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