结肠镜不同进镜次数对结直肠息肉检出率的影响及相关影响因素分析

Effect of different times of endoscopy on the detection rate of colorectal polyps and related factors

摘要:

目的 研究结肠镜不同进镜次数对结直肠息肉检出率的影响及相关因素分析。方法 纳入2015年12月－2020年12月328例接受结肠镜检查的患者作为研究对象，记录结直肠息肉检出率，比较不同进镜次数的息肉检出率。采用多因素Logistic分析探讨结肠镜漏诊的相关因素。结果 328例患者共发现368枚结直肠息肉。284例患者首次进镜检出息肉296枚，检出率为80.43%，二次进镜新检出息肉66枚，检出率为91.67%，三次进镜新检出息肉4枚，检出率为66.67%。二次进镜息肉检出率明显高于首次进镜，差异有统计学意义（P < 0.05）。二次进镜息肉检出率与三次进镜比较，差异无统计学意义（P > 0.05）。多因素Logistic回归分析显示，息肉数量、直径、形态及部位是结肠镜首次进镜漏诊的独立影响因素（P < 0.05）。多因素Logistic回归分析显示，息肉形态和息肉部位是结肠镜二次进镜漏诊的独立影响因素（P < 0.05）。结论 结肠镜二次进镜结直肠息肉检出率高，其检出率受息肉形态和部位影响。

Abstract:

Objective To study the impact of different times of endoscopy on the detection rate of colorectal polyps and related factors.Methods 328 patients who underwent colonoscopy from December 2015 to December 2020 were included as the research objects, the detection rate of colorectal polyps was recorded, the detection rates of polyps with different times of endoscopy were compared. The Logistic analysis were used to analyze the related factors of missed diagnosis of colonoscopy.Results There were 368 colorectal polyps were found in 328 patients, the polyps were found in 284 patients during the first endoscopy. 296 pieces were detected, the detection rate was 80.43%, 66 pieces were newly detected in the second entry, and the detection rate was 91.67%. 4 pieces were newly detected in the third entry, and the detection rate was 66.67%. The detection rate of secondary endoscopy were significantly higher than that of the first, the difference were statistically significant (P < 0.05). There was no significant difference in the detection rate between secondary and tertiary endoscopy (P > 0.05). Logistic regression analysis showed that the number, diameter, shape and location of polyps were independent influence factors of missed diagnosis at the first endoscopy (P < 0.05). Logistic regression analysis showed that polyp shape and polyp location were independent influence factors of missed diagnosis by secondary endoscopy (P < 0.05).Conclusion The detection rate of colorectal polyps by secondary endoscopy is high, which is affected by the shape and location of polyps.