新冠疫情期间面屏对胃肠内镜检查质量的影响。
The impact of face shields on the quality of gastrointestinal endoscopy during the COVID-19 pandemic.
机构信息
Department of Internal Medicine, Dong-A University College of Medicine, Busan, 49201, South Korea.
出版信息
BMC Gastroenterol. 2022 Jan 29;22(1):38. doi: 10.1186/s12876-022-02114-2.
BACKGROUND
Coronavirus disease 2019 (COVID-19) has become a global pandemic, with healthcare workers at a high risk of exposure. During this pandemic, endoscopists must wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission; however, few studies have reported the impact of face shields on the quality of gastrointestinal (GI) endoscopy. We aimed to determine whether the use of PPE, including face shields, affected the quality of GI endoscopy during the COVID-19 pandemic.
METHODS
The medical records of patients who had undergone screening or surveillance colonoscopy and gastric endoscopic submucosal dissection (ESD) at Dong-A University Hospital between June 2020 and March 2021 were retrospectively reviewed. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists also wore face shields. We compared GI endoscopy quality indicators between the first five months (no face shields) and the second five months (with face shields). In the non-face shield and face shield groups, we calculated the overall adenoma detection rates (ADRs), polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), complete resection rate (CRR), number of polyps and/or adenomas per colonoscopy, and gastric ESD procedure time.
RESULTS
In total, 1359 study patients had undergone screening or surveillance colonoscopy (face shield group, n = 679; non-face shield group, n = 680). No statistically significant between-group differences were observed (PDR, 49.04 vs. 52.50%, p = 0.202; ADR, 38.59 vs. 38.97%, p = 0.884; SSPDR, 1.91 vs. 1.32%, p = 0.388; ANDR, 3.98 vs. 3.97%, p = 0.991, respectively). No difference was found in colonoscopy quality indicators between patients examined by experienced and trainee endoscopists with and without face shields. Of 144 study patients who had undergone gastric ESD for gastric neoplasms, there were 72 patients in each group. No statistically significant differences were found in the CRR (94.44 vs 93.05%, p = 1.000) and procedure times (19.22 ± 9.33 vs. 19.03 ± 11.49, p = 0.911).
CONCLUSIONS
Wearing face shields during the COVID-19 pandemic did not affect the quality indicators for GI endoscopy.
背景
2019 年冠状病毒病（COVID-19）已成为全球性大流行，医护人员面临着极高的暴露风险。在这场大流行期间，内镜医生必须穿戴个人防护设备（PPE），包括面罩，以防止 COVID-19 的传播；然而，很少有研究报告面罩对胃肠道（GI）内镜质量的影响。我们旨在确定在 COVID-19 大流行期间使用 PPE（包括面罩）是否会影响 GI 内镜的质量。
方法
回顾性分析 2020 年 6 月至 2021 年 3 月期间在东亚大学医院接受筛查或监测结肠镜检查和胃内镜黏膜下剥离术（ESD）的患者的病历。内镜医生在 2020 年 6 月至 2020 年 10 月期间穿着隔离服、一次性手套和 KF94 口罩。从 2020 年 11 月开始，内镜医生还佩戴了面罩。我们比较了前五个月（无面罩）和后五个月（有面罩）的 GI 内镜质量指标。在无面罩和面罩组中，我们计算了总体腺瘤检出率（ADR）、息肉检出率（PDR）、无蒂锯齿状病变检出率（SSLDR）、高级别瘤变检出率（ANDR）、完全切除率（CRR）、每例结肠镜检查的息肉和/或腺瘤数量以及胃 ESD 手术时间。
结果
共有 1359 例研究患者接受了筛查或监测结肠镜检查（面罩组，n=679；无面罩组，n=680）。两组间无统计学差异（PDR，49.04%与 52.50%，p=0.202；ADR，38.59%与 38.97%，p=0.884；SSPDR，1.91%与 1.32%，p=0.388；ANDR，3.98%与 3.97%，p=0.991，分别）。有经验的内镜医生和受训医生在使用和不使用面罩时，结肠镜检查质量指标无差异。在 144 例因胃肿瘤接受胃 ESD 的研究患者中，每组 72 例。CRR（94.44%与 93.05%，p=1.000）和手术时间（19.22±9.33 与 19.03±11.49，p=0.911）无统计学差异。
结论
在 COVID-19 大流行期间佩戴面罩不会影响 GI 内镜的质量指标。
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