双人观察对肠镜息肉检出率影响的前瞻性研究

A prospective study for the influence of physician plus nurse observation during colonoscopy on polyp detection rate

目的了解医护双人观察在结肠镜检查退镜过程是否可以提高息肉检出率。方法连续性收集内镜室诊断性结肠镜检查患者,前瞻性地随机分医护双人观察组和医生单人观察组,记录比较两组的息肉检出率。结果在4个月研究期间共完成985例诊断性结肠镜检查,其中271例检出息肉,总704枚。498例医护双人观察组和487例医生单人观察组的息肉检出率分别为30.5%和24.4%,差异有统计学意义(P=0.032)。在医生单人观察组中,护士证实医生在21例患者中共漏检息肉27枚。结论医护双人观察在结肠镜检查退镜过程中协助医生共同观察可以提高息肉检出率。

Objective To understand whether physician plus nurse observation during colonoscopy increases polyp detection rate. Methods Consecutive patients undergoing diagnostic colonoscopy were prospectively randomized to physician plus nurse observation or only physician observation during withdrawal. Polyp detection rate was compared between the two groups. Results Of 985 patients in the four months study period, 498 were randomized to physician plus nurse double observation colonoscopy, and 487 to only physician observation during withdrawal. A total of 704 polyps in 271 patients were detected. Polyp detection rate in the physician plus nurse observation group was significantly higher than that in only physician observation group, with 30.5% vs 24.4%（P = 0.032） respectively. In the physician observation group, nurse found that 27 polyps in 21 patients were missed by physician. Conclusion Physician plus nurse observation during colonoscopy resulted in an increase in the number of polyps detection.