我国消化内镜传统诊治项目开展现状与分析：169家医院调查报告

Survey and analysis of the current status of conventional diagnostic/therapeutic gastrointestinal endoscopy： an investigation from 169 hospitals in China's Mainland

目的调查分析我国消化内镜传统诊治项目（常规胃肠镜检查、息肉切除等）开展状况。方法以国内不同省份的各级医院消化内镜单元（室）为调查对象，采用电子邮件或电话问卷方式对我国消化内镜传统诊治项目开展状况进行调查分析。率的比较采用z。检验。结果自2010年5月至Ii月，共有169家医院纳入本次调查，分布于28个省，占国内大陆省份的90．3％（28／31），其中147家医院可开展消化内镜操作，占87．0％。在这147家医院中，所有医院（100％）均可开展常规胃镜检查，93．9％（138／147）的医院可开展肠镜检查，二、三级医院肠镜开展率（97．8％、100％）高于一级医院（25．0％，x^2=60．9，P〈0．01）；所有三级医院（i00％）和79．8％（71／89）的二级医院能开展内镜下息肉切除术，明显高于一级医院（16．7％，x^2=20．0，P〈O．01）；在147家医院中，共有74家开展经内镜逆行胰胆管造影（ERCP），占50．3％，其中76．1％（35／46）的三级医院、43．8％（39／89）的二级医院可开展ERCP，三级医院高于二级医院（x^2=12．7，P〈0．01）；12家已开展消化内镜操作的一级医院中，均未开展ERCP、超声内镜检查（EUS）及食管静脉套扎＋硬化（EVL＋EVS）治疗。结论常规胃肠镜检查在我国二、三级医院已普及，一级医院还有较大提升空间；ERCP术及EVL＋EVS等传统消化内镜介入操作在三级医院较普及，二级医院有待提高。

Objective To investigate the current status of conventional diagnostic/therapeutic gastrointestinal （GI） endoscopy （conventional gastroscopy/colonoscopy and endoscopic polypectomy, et al. ） in China's Mainland. Methods The survey was conducted by a questionnaire sent via e-mail or telephone to the hospital-based GI endoscopy units, including three levels of hospitals （Third-Grade Hospital Classification in China）. Results From May 2010 to November 2010, 169/279 （60. 60//oo） units were enrolled, which covered 28 provinces （90. 3%） in China's Mainland. Among the 169 hospitals, 147 （87.0 % ） hospitals performed GI endoscopy, and all the hospitals performed gastroseopy （100%）. Furthermore, 100% of the tertiary hospitals, and 93. 9% （138/147） of the second-level hospitals performed colonoscopy, significantly higher than that of the first-level hospitals （25. 0%） （x^2=60.9,P%0.01）. All the tertiary hospitals （100%）, and 79.8% （71/89） of the second-level hospitals perform endoscopic polypectomy, significantly higher than that of the first-level hospitals （16.7 %, x^2 = 20.0, P 〈 0.01, P〈 0.05）. Among the 147 hospitals with the ability to perform GI endoscopy, 74 hospitals （50. 3%） performed endoscopic retrograde cholangiopancreatography （ERCP）. Furthermore, 76. 1% （35/46） of the tertiary hospitals performed ERCP, significantly higher than that of the second-level hospitals （43.8% ,39/89） （x^2 =12.7 ,P〈0. 01）, and none of the 12 first-level hospitals performed ERCP, endoscopic ultrosonography （EUS） or EVL/EVS（endoscopic oesophageal varices ligation/sclerotherapy）. Conclusions The conventional diagnostic GI endoscopy （routine gastroscopy and colonoscopy） was popularized in the tertiary and the second-level hospitals, and there was still much to improve for the first-level hospitals. With regard to the conventional therapeutic endoscopies, ERCP and EVL/EVS were more popular in the tertiary hospitals, while the second-level hospitals have much to improve.