国内无痛胃肠镜开展近况调查

A survey of sedated gastrointestinal endoscopy

目的调查国内医院无痛胃肠镜的开展近况。方法以国内不同省份的各级医院消化内镜中心（室）为调查对象，采用电子邮件或电话问卷调查方式对无痛胃肠镜开展情况进行汇总分析。结果共有169家医院纳入调省分析，分布于28个省（自治区或直辖市），占国内大陆省份的90．3％（28／31），其中三级医院为46家，二级医院为91家，一级医院为32家。110家（65．1％，110／169）开展了无痛胃肠镜，其中93．5％（43／46）的被调查三级医院、68．1％（62／91）的二级医院及15．6％（5／32）的一级医院开展了无痛胃肠镜，三级医院开展率明显高于二级医院（P〈0．05），二级医院则显著高于一级医院（P〈0．05）。在110家开展无痛胃肠镜的医院中，只有10家（9．1％）消化内镜室配备了专职麻醉医师，且这10家均为三级医院，占开展无痛胃肠镜三级医院的23．3％（10／43）。110家开展无痛胃肠镜的医院中，98家（89．1％）使用或联合使用丙泊酚作为镇静剂。结论国内无痛胃肠镜在过去十余年内得到迅速发展，但一、二级医院开展率仍较低，且专职麻醉医师（或麻醉护士）普遍缺少是目前面临的主要问题。

Objective To investigate the popularity of the sedated gastrointestinal endoscopy in ma- inland China. Methods The survey on the popularity of the sedated gastrointestinal endoscopy was conduc- ted with questionnaires sent by e-mails or telephones to the GI endoscopy units of three levels of hospitals. Results From May, 2010 to November, 2010, 169 units from 28 provinces （90. 3% ） were enrolled, including 46 hospitals of grade Ⅲ, 91 of grade Ⅱ and 32 of grade Ⅰ. Sedated gastrointestinal endoscopy were performed in 110 （65.1%, 110/169） hospitals, i. e. 93.5% （43/46） grade m hospitals, 68.1% （62/91） grade Ⅱ hospitals and 15.6% （5/32） grade Ⅰ hospitals. Significant difference was observed between the grade Ⅲ and the grade Ⅱ hospitals （ P 〈 0. 05 ） , so was between the grade Ⅱ and the grade Ⅰ hospitals （ P 〈 0. 05 ）. Propofol was frequently used in sedation in 98 hospitals （ 89. 1% ）. The only 9. 1% （10/110） hospitals, which had full-time anesthetists or anesthetic nurses, were all grade Ⅲ hospitals. Conclusion There has been great progress in the popularity of sedated gastrointestinal endoscopy in China's Mainland during the past decade. However, it is less frequently performed in grade Ⅰ and Ⅱ hospitals. Shortage of full-time anesthetists is still a problem.