辽宁省农村医疗机构上消化道癌早诊早治筛查能力调查

目的 调查辽宁省农村地区医疗机构胃镜使用情况及上消化道癌筛查能力,为推广上消化道癌机会性筛查提供依据。方法 采用整群抽样的方法,利用自编调查问卷,面访的形式对辽宁省10个地市的53家农村二级以上医院进行调查,分析不同级别医院的胃镜工作量、病理开展情况、内镜及病理医师数量、内镜数量及型号等信息。结果 94.3%的医院开展了胃镜筛查,其中71.7%的医院开展了上消化道癌病理学诊断,年平均开展胃镜操作数量为1650台次/医院,消化内镜医生数量平均为2.4人,病理科医生数量平均为2.2人,消化内镜数量平均为3.3条/医院,68.0%的医院单独或联合使用奥林巴斯品牌消化内镜。二级医院胃镜操作数量(t=4.563,P＜0.001)、病理学诊断开展医院数量(t=2.236,P=0.032)等多个指标弱于三级医院。食管筛查碘染色使用率为14.0%,病理学诊断率为2.8%。结论 辽宁省农村医疗机构从胃镜开展数量、医务人员数量和胃镜设备配备方面分析基本具备开展上消化道癌机会性筛查的能力,三级医院好于二级医院,但都存在机型老化、技术操作不规范等问题,在推广上消化道癌机会性筛查时,应基于基层医疗机构现状开展培训。

Screening ability of early diagnosis and treatment of upper gastrointestinal cancer in rural hospitals,Liaoning

Objective To investigate the use of gastroscopy and screening ability of upper gastrointestinal cancer in hospitals in rural areas of Liaoning Province,and to provide evidence for promoting opportunistic screening of upper gastrointestinal cancer.Methods Using the cluster sampling method and self-compiled questionnaires,53 rural hospitals above the secondary level in 10 municipalities of Liaoning Province were investigated by interview.We analyzed the workload of gastroscopy,pathological development,number of endoscopes and pathologists and number and type of endoscopes.Results 94.3% of hospitals carried out gastroscopy screening,71.7% of which carried out pathological diagnosis of upper gastrointestinal cancer.The average number of gastroscopic operations per hospital per year was 1 650.And the average numbers of digestive endoscopists,pathologists and digestive endoscopes were 2.4,2.2,3.3 per hospital,respectively.68.0% of hospitals used Olympus brand endoscopy alone or in combination.The number of gastroscopic operations(t=4.563,P<0.001)and the number of hospitals for pathological diagnosis(t=2.236,P=0.032)in second-level hospitals were weaker than those in third level hospitals.The rate of iodine staining in oesophagal screening was 14.0%,and the rate of pathological diagnosis was 2.8%.Conclusion Rural hospitals in Liaoning Province basically are able to carry out opportunistic screening for upper gastrointestinal cancer thinking of the aspects of the number of gastroscope,the number of medical staff and the equipment of gastroscope.The third-level hospitals are better than the second-level hospitals.But there are some problems such as ageing of machine type,irregular technical operation and so on.In promoting opportunistic screening for upper gastrointestinal cancer,training should be carried out based on the current situation of primary hospitals.