基于5G网络的便携式消化内镜检查远程会诊应用研究

Application of portable gastrointestinal endoscopy to telemedicine based on 5G network

摘要:

目的 依托5G通信技术，搭建便携式消化内镜检查远程会诊平台，实现内镜检查音视频数据实时传输至会诊医师，并评价远程会诊应用效果。方法 选取2023年10月10日至10月20日，16例海南省三亚市和14例广东省湛江市基层卫生所分别至上海市某三甲医院进行便携式消化内镜检查远程会诊的病例，记录5G网络传输参数，评估检查端和会诊端病变检出率、视频和图像质量。结果 三亚市和湛江市至上海市远程会诊的5G网络传输参数分别为下载网速168.3 Mbps和160.4 Mbps，上传网速75.1 Mbps和72.4 Mbps，延时28 ms和25 ms。检查端和会诊端医师的病变检出率差异无统计学意义［43.3%（13/30）比36.7%（11/30），=0.792，P=0.598］。2名高年资内镜医师分别比较了检查端和会诊端的内镜视频质量［（2.92±0.59）分比（2.88±0.64）分，t=0.302，P=0.763］和图片质量［（3.10±0.57）分比（3.05±0.53）分，t=0.424，P=0.622］，显示检查端和会诊端差异无统计学意义。结论 基于5G网络的便携式消化内镜检查远程会诊应用效果良好，实现了远程会诊和操作指导，有助于提高基层医师操作能力和疾病诊断能力，实现优质医疗资源下沉。

Abstract:

Objective To establish a portable gastrointestinal endoscopy telemedicine platform that enables the real-time transmission of endoscopy audio and video data to the consulting physicians through 5G communication technology, and to evaluate the effectiveness of this platform. Methods From October 10 to October 20, 2023, 30 cases (16 cases from Sanya, Hainan Province, and 14 cases from Zhanjiang, Guangdong Province) from primary health institutions were selected for portable gastrointestinal endoscopy telemedicine consultations with a tertiary hospital in Shanghai. 5G network transmission parameters were recorded, and the lesion detection rate of the examination side and the consultation side, as well as the quality of the videos and images were compared. Results The 5G network transmission parameters for telemedicine from Sanya and Zhanjiang to Shanghai included download network speeds of 168.3 Mbps and 160.4 Mbps, upload network speeds of 75.1 Mbps and 72.4 Mbps, and delays of 28 ms and 25 ms, respectively. There was no significant difference in the lesion detection rate [43.3% (13/30) VS 36.7% (11/30), =0.792, P=0.598] between the physicians on the examination side and the consultation side. The endoscopic video quality (2.92±0.59 points VS 2.88±0.64 points, t=0.302, P=0.763) and picture quality (3.10±0.57 points VS 3.05±0.53 points, t=0.424, P=0.622) were compared by two senior endoscopists between the examination side and the consultation side, indicating no significant difference. Conclusion The utilization of portable gastrointestinal endoscopy for telemedicine based on 5G network technology is effective in enabling telemedicine consultations and providing operational guidance. This approach enhances the procedural skills and diagnostic capabilities of physicians in primary healthcare settings, facilitating the equitable distribution of high-quality medical resources.