McAlindon Mark E, Parker Clare E, Hendy Philip, Mosea Haider, Panter Simon, Davison Carolyn, Fraser Chris, Despott Edward J, Sidhu Reena, Sanders David S, Makins Richard
Department of Gastroenterology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
Department of Gastroenterology, South Tyneside District Hospital, South Tyneside, UK.
Frontline Gastroenterol. 2012 Apr;3(2):98-103. doi: 10.1136/flgastro-2011-100044. Epub 2011 Dec 12.
To determine the location and use of small bowel endoscopy services in the UK and to analyse training uptake to assess future demand and shape discussions about training and service delivery.
Surveys of British Society of Gastroenterology (BSG) members by web-based and personal contact were conducted to ascertain capsule endoscopy practice and numbers of procedures performed. This was compared with expected numbers of procedures calculated using BSG guidelines, hospital episode statistics and published data of capsule endoscopy in routine practice. Analysis of data from two national training courses provided information about training.
45% of UK gastroenterology services offered in-house capsule endoscopy. 91.3% of survey responders referred patients for capsule endoscopy; 67.7% felt that local availability would increase referrals. Suspected small bowel bleeding and Crohn's disease were considered appropriate indications by the majority. Demand is increasing in spite of restricted use in 21.6% of centres. Only two regions performed more than the minimum estimate of need of 45 procedures per 250 000 population. Eight centres perform regular device-assisted enteroscopy; 14 services are in development. 74% of trainees were interested in training and of those training in image interpretation, 67% are doctors and 28% are nurses.
Capsule endoscopy is used by the majority of UK gastroenterologists but appears to be underused. Current demand for device-assisted enteroscopy seems likely to be matched if new services become established. Future demand is likely to increase, however, suggesting the need to formalise training and accreditation for both doctors and nurses.
确定英国小肠内镜检查服务的地点和使用情况，并分析培训参与度，以评估未来需求并为培训及服务提供方式的讨论提供依据。
通过网络和个人联系对英国胃肠病学会（BSG）成员进行调查，以确定胶囊内镜检查的实践情况和操作数量。将其与根据BSG指南、医院病历统计数据以及常规实践中已发表的胶囊内镜检查数据计算出的预期操作数量进行比较。对两个全国性培训课程的数据进行分析，以获取有关培训的信息。
英国45%的胃肠病学服务机构提供院内胶囊内镜检查。91.3%的调查受访者会将患者转诊进行胶囊内镜检查；67.7%的人认为当地可提供该检查会增加转诊量。大多数人认为疑似小肠出血和克罗恩病是合适的适应症。尽管21.6%的中心使用受限，但需求仍在增加。只有两个地区的操作量超过了每25万人口45例的最低估计需求量。八个中心定期进行器械辅助小肠镜检查；14项服务正在开展中。74%的学员对培训感兴趣，在接受图像解读培训的人员中，67%是医生，28%是护士。
英国大多数胃肠病学家使用胶囊内镜检查，但似乎存在使用不足的情况。如果建立新的服务，目前对器械辅助小肠镜检查的需求似乎有可能得到满足。然而，未来需求可能会增加，这表明需要对医生和护士的培训及认证进行规范。
