三罗地区医务人员的大肠腺瘤性息肉防治知识调查及其筛查模式研究

Investigation on the prevention and treatment knowledge of colorectal adenomatous polyps among medical staff in Sanluo area and its screening model research

目的探讨三罗地区医务人员的大肠腺瘤性息肉防治知识认知程度及其筛查模式。方法于2016年1月至2018年6月选取三罗地区(罗店、罗南、罗泾)一、二级医院689名医务人员作为筛查对象,对入选对象开展腺瘤性息肉防治知识的问卷调查,同时选择免疫法粪便隐血试验(iFOBT)和腺瘤性息肉危险因素评估量表(RFAS)进行初筛,结肠镜检查进行复筛。结果①一、二级医院医务人员对腺瘤性息肉防治知识知晓率较低的条目依次为高危人群(56.89%)、癌前病变(55.59%)、危险因素(32.66%)、早期症状(41.65%)、早期发现(34.25%)、化疗适应证(37.16%)、放疗时机(38.32%);②iFOBT法、RFAS法及iFOBT法联合RFAS法对腺瘤性息肉的初筛阳性率分别为7.84%、12.34%、17.85%,依次递增,差异有统计学意义(P<0.05);③iFOBT法、RFAS法及iFOBT法联合RFAS法对非腺瘤性息肉、普通腺瘤、进展期腺瘤、大肠息肉的检出率分别依次递增,差异均有统计学意义(均P<0.05);而对大肠癌的检出率分别0.15%、0.15%、0.15%,差异无统计学意义(P>0.05);④三罗地区689名医务人员腺瘤性息肉检出率为4.50%。结论三罗地区医务人员的大肠腺瘤性息肉防治知识认知程度偏低;采用iFOBT法联合RFAS法初筛、结肠镜检查复筛是腺瘤性息肉筛查的理想模式。

Objective To explore the awareness of medical staff in Sanluo area on the prevention and treatment knowledge of colorectal adenomatous polyps and its screening model. Methods From January 2016 to June2018, 689 medical staffs from the first and second level hospitals in Sanluo area(Luodian, Luonan, and Luojing) were selected as the screening subjects. Questionnaire surveyed among them on the prevention and treatment knowledge of adenomatous polyps. At the same time, immunological fecal occult blood test(iFOBT) and Risk Factor Assessment Scale(RFAS) were used for primary screening and colonoscopy for secondary screening. Results ① Among medical staffs from the first and second level hospitals, the items with low awareness rate about the prevention and treatment knowledge of adenomatous polyps were successively the high-risk population(56.89%), precancerous lesions(55.59%), risk factors(32.66%), early symptoms(41.65%), early detection(34.25%), indications for chemotherapy(37.16%), and timing of radiotherapy(38.32%).② The primary screening positive rates of iFOBT, RFAS and the combination of iFOBT and RFAS for adenomatous polyps was 7.84%, 12.34% and 17.85%, respectively, which was increased in turn, and all differences were statistically significant(P<0.05).③ By iFOBT, RFAS and the combination of iFOBT and RFAS, the detection rate of non-adenomatous polyps, common adenomas, advanced adenomas, and colorectal polyps was respectively increased in turn, all differences were statistically significant(P<0.05);while the detection rate of colorectal cancer was respectively 0.15%, 0.15%, and 0.15%(P>0.05).④ The detection rate of adenomatous polyps was 4.50% in 689 medical staffs in Sanluo area. Conclusion Medical staffs in Sanluo area have low awareness of the prevention and treatment knowledge of colorectal adenomatous polyps. The use of iFOBT combined with RFAS for primary screening and colonoscopy for secondary screening is an ideal screening mode for adenomatous polyps.