食管胃黏膜异位内镜检出率的影响因素分析

Analysis of the factors affecting the endoscopic detection rate of heterotopic gastric mucosa of the esophagus

目的探讨影响食管胃黏膜异位(HGME)内镜检出率的影响因素,以提高HGME的内镜检出率。方法回顾性分析2018年1月-2018年12月在柳州市人民医院行胃镜检查的患者19948例。记录患者年龄、性别、胃镜检查方式、胃镜检查模式和胃镜医师级别等,分析HGME检出率的影响因素。结果检出HGME 282例,总检出率为1.41%(282/19948)。不同组别发现的HGME病例数如下:无痛胃镜组226例(1.53%),普通胃镜组56例(1.07%);NBI组89例(3.06%),普通白光组193例(1.13%);按胃镜医师级别分组,住院医师及低年资主治医师组37例(0.89%),高年资主治医师组93例(1.48%),副主任医师及以上组152例(1.59%)。经统计学分析,胃镜检查方式、胃镜检查模式和医师分级对HGME检查率均有影响(P<0.05),而患者年龄和性别对HGME检出率无明显影响。结论HGME检出率与胃镜检查方式、胃镜检查模式和医师分级相关,无痛胃镜、NBI模式、内镜医师经验的积累均能明显提高HGME的检出率。

Objective To explore the factors affecting endoscopic detection rate of heterotopic gastric mucosa in the esophagus(HGME),improve the endoscopic detection rate of HGME.Methods Retrospective analysis of 19948 patients underwent gastroscopy from January to December 2018 was made.Record age and gender of the patients,gastroscopy mode,gastroscopy pattern,gastroscopy doctor level,etc.Analyse the factors affecting the endoscopic detection rate of HGME.Results 282 cases were found HGME,the overall detection rate is 1.41%.The number of HGME cases found in different groups is as follows:226 cases of painless gastroscopy group(1.53%),and 56 cases of general gastroscopy group(1.07%);89 cases in NBI group(3.06%)and 193 cases of ordinary white light group(1.13%);37 cases in resident and low seniority attending physician group(0.89%),93 cases in senior attending physician(1.48%),152 cases in senior professional physician group(1.59%).Accord to statistical analysis,gastroscopy mode,gastroscopy pattern,gastroscopy doctor leve have an impact on the endoscopic detection rate of HGME(P<0.05),the age and gender of patient have no significant impact on the endoscopic detection rate of HGME.Conclusion The endoscopic detection rate of HGME is related to gastroscopy mode,gastroscopy pattern and doctor experience,painless gastroscopy,NBI mode and the experience accumulation of endoscopists can significantly improve the detection rate of HGME.