做了肠镜等于白做?短期发生癌症,首诊漏检占 52%(6)
更新时间:2022-11-06
「质控标准也在与时俱进,其中已经有了基层医院的身影。」柏愚副主任进一步谈及对基层医院的更多期待。 「而这一切的基础,就是根据标准,高质量地做好内镜。」 致谢:本文经 上海长海医院消化内科主任医师 柏愚、 中南大学湘雅三医院消化内科主治医师 唐岸柳 专业审核 文中「刘宁」为化名 策划:云也 | 监制:gyouza 参考文献: [1] Zauber AG, Winawer SJ, O'Brien MJ , et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012 Feb 23;366(8):687-96. [2] Zhao S, Wang S, Pan P, et al. Magnitude, risk factors, and factors associated with adenoma miss rate of tandem colonoscopy: a systematic review and meta‐analysis[J]. Gastroenterology, 2019,156(6):1661‐1674.e11. [3] 王成龙, 等. 结肠镜检查质量控制研究进展结. 结直肠肛门外科. 2021;27:527-530,535. [4] 国家消化系统疾病临床医学研究中心(上海),国家消化道早癌防治中心联盟,中华医学会消化内镜学分会,等. 中国早期结直肠癌筛查流程专家共识意见(2019,上海)[J]. 中华消化内镜杂志. 2019,36(10):709-719. [5] 《2021中国县域医院消化内镜基本请况调查》 [6] 消化内镜诊疗技术医疗质量控制指标(2022 年版):37fef257647d438099eb43753c0aa79b.pdf (nhc.gov.cn) [7] Kaminski MF, Regula J, Kraszewska E, et al. Quality indicators for colonoscopy and the risk of interval cancer[J]. N Engl J Med, 2010, 362(19):1795-1803. [8] Corley DA, Jensen CD, Marks AR, et al. Adenoma detection rate and risk of colorectal cancer and death[J]. N Engl J Med, 2014,370(14):1298‐1306. [9] 王邦茂, 姚双喆. 加强结肠镜检查的质量控制提高大肠癌早期检出率[J]. 中华内科杂志, 2017, 56(8):3. [10] Barclay RL, Vicari JJ, Doughty AS, et al. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy[J]. N Engl J Med, 2006,355(24):2533‐2541. [11] Zhao S,Yang X,Wang S,et al.Impact of 9-minute Withdrawal Time on the Adenoma Detection Rate:A Multicenter Randomized Controlled Trial[published online ahead of print,2020 Nov 18].Clin Gastroenterol Hepatol.2022;20(2):e168-e181. [12] Kaminski MF, Anderson J, Valori R, et al. Leadership training to improve adenoma detection rate in screening colonoscopy: a randomised trial[J]. Gut, 2016,65(4):616-624. |