2021国家消化内镜诊疗服务与质量安全报告

Endoscopy in China: a national survey on the services, quality and safety of digestive endoscopy in 2021

摘要:

目的 评价2020年我国消化内镜诊疗服务质量。方法 纳入国家医疗质量信息网络收集的2020年消化内镜相关数据，进行数据质量评价和筛选后，对我国整体和不同类型医院消化内镜中心基本情况、消化内镜诊疗情况、消化内镜过程与结果指标进行分析和比较。结果 调查共纳入3 714家医院，各医院完成消化内镜诊疗例次3 562.5（1 299.75，8 426.75）例次，消化内镜医师数4（2， 7）名，人均年完成内镜操作900（500，1 452）例次。消化道早期癌内镜检出率为17.46%（110 069/630 265），结肠镜盲肠插管成功率为95.43%（6 976 521/7 310 970），经内镜逆行胰胆管造影术选择性深插管成功率为94.21%（121 666/129 149），内镜黏膜下剥离术完全切除率为92.68%（93 536/100 924）。消化内镜诊疗相关严重并发症发生率［0.05‰（1 316/26 499 108）］及死亡率［0.003‰（80/26 499 108）］保持在较低水平。结论 2020年我国消化内镜诊疗质量及安全性整体较高，但仍存在消化内镜人力资源短缺、内镜医师消化道早期肿瘤诊断能力较差的问题。

Abstract:

Objective To evaluate the services, quality and safety of digestive endoscopy in China in 2020. Methods Data of digestive endoscopy in 2020 collected by the national medical quality information network were included. After data quality evaluation, the basic information of digestive endoscopy centers in different types of hospitals, the diagnosis and treatment of digestive endoscopy, the process and outcome indicators of digestive endoscopy were analyzed and compared. Results A total of 3 714 hospitals were included in this survey. The digestive endoscopy operations completed by each hospital was 3 562.5 (1 299.75, 8 426.75), the digestive endoscopists was 4 (2, 7), and the endoscopic operations completed per capita per year was 900 (500, 1 452). The detection rate of early gastrointestinal cancer was 17.46% (110 069/630 265). The success rates of cecal intubation under colonoscopy and selective intubation of endoscopic retrograde cholangiopancreatography were 95.43% (6 976 521/7 310 970) and 94.21% (121 666/129 149) respectively. The complete resection rate of endoscopic submucosal dissection was 92.68% (93 536/100 924). The incidence of serious complications related to digestive endoscopic operations [0.05‰ (1 316/26 499 108)] and mortality [0.003‰ (80/26 499 108)] remained at a low level. Conclusion The quality and safety of digestive endoscopy in China in 2020 is improved, but there are still some problems, such as the shortage of digestive endoscopists, the poor ability of endoscopists in the diagnosis of early gastrointestinal cancer.