食管胃黏膜异位检出率的影响因素分析及其对食管检查质量评价的研究

摘要

Objective To study the factors affecting endoscopic detection of heterotopic gastric mucosa of the esophagus(HGME),and to discuss whether HGME is considered as a evaluation index of quality of esophageal endoscopy.Methods Prospective clinical study was performed on patients who received gastroscopy.Research data included endoscopist experience,withdrawal time of the esophagus,sedation endoscopy were recorded.HGME detection rates and the factors influencing HGME in gastroscopy were analyzed.Results A total of 2 000 patients were included in this paper,of which 194 were found to have heterotopic gastric mucosa of the esophagus,the detection rate was 9.7%.The experience level of HGME group was higher than that of non HGME group,and the rate of sedation endoscopy was higher than that of non HGME group,the withdrawal time was longer than that of non HGME group,the difference was statistically significant(P<0.05),and the detection rate of HGME was increased with the increase of physician experience.Correlation analysis showed that physician experience was positively related to HGME detection rate(rs=0.685,P=0.001).Conclusion Detection rate of heterotopic gastric mucosa of the esophagus could be regard as an evaluation index of esophagus quality control.%目的 观察食管胃黏膜异位(heterotopic gastric mucosa of the esophagus,HGME)检出率的影响因素,探讨其作为食管内镜检查质量评估指标的可能性.方法 对接受胃镜检查者进行前瞻性临床调查研究,患者在行内镜检查时,记录患者是否行无痛胃镜、内镜操作医师经验级别、食管观察时间等.分析HGME检出率及其影响因素.结果 2 000例检查者中共检出HGME 194例,HGME检出率为9.7%,总共发现HGME 251处,平均HGME数为0.126(251/2 000),平均阳性HGME数为1.294(251/194).HGME组医师经验级别高于非HGME组,使用无痛胃镜率高于非HGME组,食管观察时间长于非HGME组,差异有统计学意义(P＜0.05).医师经验不同HGME检出率差异有统计学意义(P＜0.05),随医师经验增加HGME检出率有增高的趋势.相关性分析结果显示,医师经验和HGME检出率呈正相关(rs=0.685,P=0.001).结论 HGME检出率的高低与内镜检查医师经验、麻醉状态下检查、食管观察时间有关.HGME的检出率可作为评价食管检查质量的指标.方法 对接受胃镜检查者进行前瞻性临床调查研究,患者在行内镜检查时,记录患者是否行无痛胃镜、内镜操作医师经验级别、食管观察时间等.分析HGME检出率及其影响因素.结果 2 000例检查者中共检出HGME 194例,HGME检出率为9.7%,总共发现HGME 251处,平均HGME数为0.126(251/2 000),平均阳性HGME数为1.294(251/194).HGME组医师经验级别高于非HGME组,使用无痛胃镜率高于非HGME组,食管观察时间长于非HGME组,差异有统计学意义(P＜0.05).医师经验不同HGME检出率差异有统计学意义(P＜0.05),随医师经验增加HGME检出率有增高的趋势.相关性分析结果显示,医师经验和HGME检出率呈正相关(rs=0.685,P=0.001).结论 HGME检出率的高低与内镜检查医师经验、麻醉状态下检查、食管观察时间有关.HGME的检出率可作为评价食管检查质量的指标.