三罗地区医务人员的大肠腺瘤性息肉防治知识调查及其筛查模式研究
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摘要
目的探讨三罗地区医务人员的大肠腺瘤性息肉防治知识认知程度及其筛查模式。方法于2016年1月至2018年6月选取三罗地区(罗店、罗南、罗泾)一、二级医院689名医务人员作为筛查对象,对入选对象开展腺瘤性息肉防治知识的问卷调查,同时选择免疫法粪便隐血试验(iFOBT)和腺瘤性息肉危险因素评估量表(RFAS)进行初筛,结肠镜检查进行复筛。结果①一、二级医院医务人员对腺瘤性息肉防治知识知晓率较低的条目依次为高危人群(56.89%)、癌前病变(55.59%)、危险因素(32.66%)、早期症状(41.65%)、早期发现(34.25%)、化疗适应证(37.16%)、放疗时机(38.32%);②iFOBT法、RFAS法及iFOBT法联合RFAS法对腺瘤性息肉的初筛阳性率分别为7.84%、12.34%、17.85%,依次递增,差异有统计学意义(P<0.05);③iFOBT法、RFAS法及iFOBT法联合RFAS法对非腺瘤性息肉、普通腺瘤、进展期腺瘤、大肠息肉的检出率分别依次递增,差异均有统计学意义(均P<0.05);而对大肠癌的检出率分别0.15%、0.15%、0.15%,差异无统计学意义(P>0.05);④三罗地区689名医务人员腺瘤性息肉检出率为4.50%。结论三罗地区医务人员的大肠腺瘤性息肉防治知识认知程度偏低;采用iFOBT法联合RFAS法初筛、结肠镜检查复筛是腺瘤性息肉筛查的理想模式。
Objective To explore the awareness of medical staff in Sanluo area on the prevention and treatment knowledge of colorectal adenomatous polyps and its screening model. Methods From January 2016 to June2018, 689 medical staffs from the first and second level hospitals in Sanluo area(Luodian, Luonan, and Luojing) were selected as the screening subjects. Questionnaire surveyed among them on the prevention and treatment knowledge of adenomatous polyps. At the same time, immunological fecal occult blood test(iFOBT) and Risk Factor Assessment Scale(RFAS) were used for primary screening and colonoscopy for secondary screening. Results ① Among medical staffs from the first and second level hospitals, the items with low awareness rate about the prevention and treatment knowledge of adenomatous polyps were successively the high-risk population(56.89%), precancerous lesions(55.59%), risk factors(32.66%), early symptoms(41.65%), early detection(34.25%), indications for chemotherapy(37.16%), and timing of radiotherapy(38.32%). ② The primary screening positive rates of iFOBT, RFAS and the combination of iFOBT and RFAS for adenomatous polyps was 7.84%, 12.34% and 17.85%, respectively, which was increased in turn, and all differences were statistically significant(P<0.05). ③ By iFOBT, RFAS and the combination of iFOBT and RFAS, the detection rate of non-adenomatous polyps, common adenomas, advanced adenomas, and colorectal polyps was respectively increased in turn, all differences were statistically significant(P<0.05); while the detection rate of colorectal cancer was respectively 0.15%, 0.15%, and 0.15%(P>0.05). ④ The detection rate of adenomatous polyps was 4.50% in 689 medical staffs in Sanluo area. Conclusion Medical staffs in Sanluo area have low awareness of the prevention and treatment knowledge of colorectal adenomatous polyps. The use of iFOBT combined with RFAS for primary screening and colonoscopy for secondary screening is an ideal screening mode for adenomatous polyps.
Objective To explore the awareness of medical staff in Sanluo area on the prevention and treatment knowledge of colorectal adenomatous polyps and its screening model. Methods From January 2016 to June2018, 689 medical staffs from the first and second level hospitals in Sanluo area(Luodian, Luonan, and Luojing) were selected as the screening subjects. Questionnaire surveyed among them on the prevention and treatment knowledge of adenomatous polyps. At the same time, immunological fecal occult blood test(iFOBT) and Risk Factor Assessment Scale(RFAS) were used for primary screening and colonoscopy for secondary screening. Results ① Among medical staffs from the first and second level hospitals, the items with low awareness rate about the prevention and treatment knowledge of adenomatous polyps were successively the high-risk population(56.89%), precancerous lesions(55.59%), risk factors(32.66%), early symptoms(41.65%), early detection(34.25%), indications for chemotherapy(37.16%), and timing of radiotherapy(38.32%). ② The primary screening positive rates of iFOBT, RFAS and the combination of iFOBT and RFAS for adenomatous polyps was 7.84%, 12.34% and 17.85%, respectively, which was increased in turn, and all differences were statistically significant(P<0.05). ③ By iFOBT, RFAS and the combination of iFOBT and RFAS, the detection rate of non-adenomatous polyps, common adenomas, advanced adenomas, and colorectal polyps was respectively increased in turn, all differences were statistically significant(P<0.05); while the detection rate of colorectal cancer was respectively 0.15%, 0.15%, and 0.15%(P>0.05). ④ The detection rate of adenomatous polyps was 4.50% in 689 medical staffs in Sanluo area. Conclusion Medical staffs in Sanluo area have low awareness of the prevention and treatment knowledge of colorectal adenomatous polyps. The use of iFOBT combined with RFAS for primary screening and colonoscopy for secondary screening is an ideal screening mode for adenomatous polyps.
引文
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[2]蔡滨欣,计凤妹,柳胜生,等.上海市松江区居民大肠癌筛查结果分析[J].健康教育与健康促进,2016,11(1):22-24.
[3]赵瑞娟,黄建忠,潘丽红,等.上海奉贤区某社区居民大肠癌筛查结果分析[J].上海医药,2017,38(22):45-47.
[4]吴永梅,李文娟,罗酩,等.血胰岛素样生长因子和胰岛素抵抗指数测定在大肠癌癌前病变诊疗中的价值[J].中国肿瘤临床与康复,2018,25(08):972-975.
[5]罗酩,吴永梅,李文娟,等.罗店地区医务人员腺瘤性息肉筛查结果及相关危险因素知晓率评估[J].世界华人消化杂志,2017,25(28):2579-2582.
[6]翟爱军,陈洪,王贵齐,等.三种结直肠癌筛查方法比较研究[J].中国全科医学,2016,19(02):170-173.
[7]刘琰,袁东红,安太,等.大肠癌发病危险因素研究进展[J].陕西医学杂志,2016,45(11):1561-1562.
[8]肖春丽,游凯,程文龙,等.北京市顺义区大肠癌筛查745例肠镜检查结果分析[J].肿瘤预防与治疗,2016,29(4):239-241.
[9]刘明庆.大肠上皮内瘤变内镜活检与术后病理的一致性及影响因素分析[D].吉林大学,2016.
[10]孙东辉.543例大肠管状腺瘤性息肉及其癌变的临床特征分析[J].甘肃医药,2017,36(9):705-707.
[11]赵才翰.结直肠腺瘤性息肉经内镜切除术后复发影响因素分析[D].长春:吉林大学,2017.
[12]单宏鹏,张猛,陈锋,等.广西南宁西乡塘地区结直肠癌全结肠镜筛查结果分析[J].济南:山东医药,2017,57(9):94-96.
[13]臧媛.宁夏地区干部体检人群结肠镜检查结果分析[D].银川:宁夏医科大学,2017.
[14]周汝杨.早期大肠癌内镜下治疗后5年生存率、复发与再发率及中药干预作用研究[D].南京:南京中医药大学,2018.
[15]李燕.自然人群大肠癌筛查及危险因素的病例对照研究[D].银川:宁夏医科大学,2018.
[16]尹引连,黄绳武.两种动态监控筛查大肠癌及腺瘤性息肉的效果比较[J].实用医技杂志,2018,25(1):18-20.