江苏省二级以上中医院消化内镜专业现状调研及建议

Investigation and recommendations for the current state of gastrointestinal endoscopy discipline in secondary and higher traditional Chinese medical institutions in Jiangsu province

摘要:

目的 为了解江苏省二级以上中医院消化内镜建设现状，促进消化专业中西医结合，强化中西医临床协作，提升中医医疗机构消化内镜建设。方法 受省卫生健康委员会委托，开展江苏省二级以上中医院消化内镜建设现状调研。采取网络直接填报的方式，对江苏省二级以上中医院消化内镜建设现状进行普查，普查的内容包括医院概况、消化内镜硬件设施、医护人力资源、诊疗项目及诊疗技术提升需求这5个方面。结果 截至2023年12月，共收到覆盖全省13个地级市主要区域的72家中医院调研表。72家中医院共配备内镜主机244台，内镜镜杆1 570条，参与消化内镜诊疗医师780名，内镜室护理人员317名。2020至2022年每年内镜诊疗总量逐年上升，2022年达716 747例。内镜下息肉切除术治疗患者53 766例，开展精查或放大内镜检查患者5 908例，胶囊内镜检查患者261例，小肠镜检查患者256例，微探头超声内镜检查患者2 384例，内镜黏膜下剥离术治疗患者2 797例，内镜逆行胰胆管造影术治疗患者1 186例。二级甲等医院、三级乙等医院、三级甲等医院在消化内镜硬件设施、医护人力资源、开展诊疗项目方面存在差异。各单位均表示进一步开展内镜培训需求强烈。结论 全省中医医疗系统在消化内镜建设方面现况良好，但还存在资源分布不均、分级诊疗能力参差不齐、人才培养机制匮乏、质量控制体系尚不完善等问题，建议进一步优化资源配置、提高分级诊疗能力、加强内镜质量控制，以提升中医医疗机构的消化内镜建设水平。

Abstract:

Objective To assess the current state of gastrointestinal endoscopy discipline in secondary and higher traditional Chinese medical hospitals in Jiangsu province, to promote the integration of traditional Chinese medicine (TCM) and western medicine in the field of gastroenterology, to enhance the clinical cooperation between TCM and western medicine clinicians, and to improve the infrastructure of gastrointestinal endoscopy in traditional Chinese medical institutions. Methods Entrusted by Jiangsu Commission of Health, an investigation into gastrointestinal endoscopy discipline in secondary and higher traditional Chinese medical hospitals was conducted. An online direct reporting system was utilized to conduct a census with regard to five aspects: hospital profiles, endoscopy unit infrastructure, medical and nursing staff resources, diagnostic and treatment procedures, and identified areas requiring technological advancements. Results By December 2023, questionnaires from 72 traditional Chinese medical hospitals had been received from 13 prefecture-level cities in the province. These hospitals collectively possessed 244 endoscopy mainframes and 1 570 endoscope rods, with 780 endoscopists and 317 nurses specializing in digestive endoscopy care. From 2020 to 2022, annual endoscopic diagnoses and treatments increased, reaching 716 747 in 2022. Moreover, notable procedures included endoscopic polypectomies (53 766), precise or magnifying endoscopic examinations (5 908), capsule endoscopies (261), enteroscopies (256), endoscopic ultrasonography-mini probe examinations (2 384), endoscopic submucosal dissection treatments (2 797), and endoscopic retrograde cholangiopancreatography procedures (1 186). Differences existed in endoscopy unit infrastructure, medical and nursing staff resources, diagnostic and treatment procedures among Class Ⅱ Grade A, Class Ⅲ Grade B and Class Ⅲ Grade A hospitals. All units have expressed a strong desire for further endoscopy training. Conclusion The gastrointestinal endoscopy infrastructure in traditional Chinese medical institutions in Jiangsu province demonstrates commendable progress. However, there are also challenges such as uneven resource distribution, varying capabilities across different care levels, insufficient talent cultivation mechanisms, and a lack of standardized quality control systems persist. To address these issues, it is recommended that resource allocation be optimized, diagnostic and treatment capabilities be enhanced at different care levels, and endoscopy quality control measures be strengthened to improve gastrointestinal endoscopy services in traditional Chinese medical institutions.