健康管理在体检人群便潜血试验定量检测中的应用价值

The application value of health management in quantitative detection of fecal occult blood test in physical examination people

目的探讨健康管理策略在便潜血试验定量检测中的应用价值。方法组建健康管理小组;查找省医保公务员在行便潜血试验定量检测中依从性不高的原因,制定相关的健康管理策略,对2019年8月1日后体检套餐中含有便潜血试验定量检测项目的人群实施健康管理并跟进病理结果。比较实施健康管理前后体检者的参检率、弃检率、标本合格率;检后阳性者的平均随访次数、肠镜精检率、疾病检出率及总体满意度。结果2019年体检人群选择便潜血试验定量项目的共2257人,2019年8月1日前选取此项目的共1100人,参检121人(11.00%)、弃检979人(89.00%)、留取标本合格60人(49.58%);实施健康管理后选取此项目的共1157人,参检627人、弃检530人,标本合格568人,参检率、弃检率、标本合格率分别为54.19%、45.81%、90.59%。管理前后比较差异均有统计学意义(P<0.01)。检后结果阳性共58人,健康管理前结果阳性共12人,平均随访次数2次、行肠镜检查2人、检出疾病2人、满意度调查3人满意,行肠镜检查的精检率、疾病检出率、总体满意度分别为16.67%、16.67%、25.00%;健康管理后结果阳性共46人,平均随访次数4.3次、行肠镜检查32人、检出疾病26人、满意度调查40人满意,行肠镜检查的精检率、疾病检出率、总体满意度分别为69.57%、56.53%、86.96%。管理前后比较差异均有统计学意义(P<0.01)。结论健康管理能提高体检人群便潜血试验定量检测的参检率、标本合格率,降低弃检率,加强检后随访与多学科团队协作增加了检后阳性人群进一步肠镜精检率、疾病检出率和满意度,值得应用。

Objective To investigate the heaith management strategy and application value for the provincial medical insurance civil servants who undergo the stool occult blood test.Methods A health management team was established and its personnel were trained to fing out the reasons for the lower compliance of provincial medical insurance civil servants in the quantitative detection of occult blood testnthen to make relevant health management strategies.The health management and follow-up of pathological results were performed for the people who underwent stool occult blood test in physical examination package,and the rate of taking physical examination,the rate of rejecting physical examination,the rate of passing specimen,the average times of follow-up,and enteroscopy rate,disease detection rate and the overall satisfaction degree were observed and compared before and after the implementation of health management.Results In 2019,there were 2,257 subjects who chose the quantitative detection item of stool occult blood Test.Before August 1,2019,there were 1,100 people who chose this item,of whom,121 subjects participated in the examination,979 people abandoned the examination,and 60 subjects kept qualifiedly the specimen.The rate of taking physical examination,the rate of rejecting physical examination and specimen qualification rate were 11.00%,89.00%,49.58%respectively,and there were significant differences before health management and after health management(P<0.01).After the physical examination,there were 58 subjects with positive results,12 subjects with positive results before health management,2 patients who underwent enteroscopy.The accuracy rate of enteroscopy,disease detection rate and overall satisfaction rate were 16.67%,16.67%,25.00%respectively.After health management,there were 46 subjects with positive results,with mean follow-up times being 4.3 times,and 32 subjects who underwent enteroscopy,26 patients with disease,40 patients were satisfied with the satisfaction survey.The accuracy rate of enteroscopy,disease detection rate and overall satisfaction rate were 69.57%,56.53%,86.96%respectively,there were significant differences before health management and after health management(P<0.01).Conclusion The implementation of health management can improve the reference rate,the qualification rate of specimens of quantitative detection of fecal occult blood test in physical examination population,and can reduce the rate of abandoned examination,and the enhanceing post-test follow-up and multi-disciplinary team cooperation can improve the disease detection rate and satisfaction degree,which is worthy of application and promotion.