Weng Shu-Chao, Lee Hung-Chang, Yeung Chun-Yan, Chan Wai-Tao, Lao Hsuan-Chih, Jiang Chuen-Bin
Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan.
Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hsinchu Municipal MacKay Children's Hospital, Hsinchu City, Taiwan.
Pediatr Neonatol. 2024 May;65(3):260-265. doi: 10.1016/j.pedneo.2023.05.009. Epub 2023 Oct 21.
To assess the quality change of our single-center pediatric colonoscopy after applying bundle for bowel preparation and general anesthesia and centralize the procedure using terminal ileum (TI) intubation rate as the main indicator.
All elective colonoscopies performed for patients younger than 18 years old in MacKay Memorial Hospital from July 2015 through June 2020 (assigned to group 1, before bundle) and from August 2020 through July 2021 (assigned to group 2, after bundle) were retrospectively reviewed for demographic characteristics, indications, bowel preparation agent and cleansing level, diagnostic and therapeutic procedures, maximum intestinal level reached, and cecal intubation and total procedure time. Statistical analysis was done using P value < 0.05 considered to be significant.
Analysis included 45 and 32 colonoscopies in group 1 and 2, respectively. Bloody stool was the most frequent indication in both groups. Both TI intubation rate (42.2 % vs. 75.0 %, P = 0.004) and biopsy rate (45.0 % vs. 75.9 %, P = 0.01) increased significantly from group 1 to group 2. The narrower standard deviation of bowel preparation score (1.93 vs. 1.15) and total procedure time (37.71 vs. 22.29) in group 2 indicated a more stable quality, although the mean showed no difference. There was no statistical difference in age, gender, body weight, cecal intubation rate, or cecal intubation time.
A higher TI intubation rate and biopsy rate indicated an improved quality of pediatric colonoscopy after applying bundle including bowel preparation and general anesthesia, with additional centralization.
应用肠道准备和全身麻醉套餐并以回肠末端（TI）插管率作为主要指标集中操作流程后，评估我院单中心儿科结肠镜检查的质量变化。
回顾性分析2015年7月至2020年6月在麦凯纪念医院为18岁以下患者进行的所有择期结肠镜检查（归入第1组，套餐应用前）以及2020年8月至2021年7月进行的所有择期结肠镜检查（归入第2组，套餐应用后），内容包括人口统计学特征、适应证、肠道准备药物及清洁程度、诊断和治疗操作、到达的最大肠段水平、盲肠插管情况及总操作时间。采用P值<0.05为有统计学意义进行统计分析。
第1组和第2组分别纳入45例和32例结肠镜检查病例。两组中便血都是最常见的适应证。从第1组到第2组，TI插管率（42.2%对75.0%，P = 0.004）和活检率（45.0%对75.9%，P = 0.01）均显著提高。第2组肠道准备评分的标准差更窄（1.93对1.15）以及总操作时间更短（37.71对22.29），表明质量更稳定，尽管均值无差异。年龄、性别、体重、盲肠插管率或盲肠插管时间方面无统计学差异。
更高的TI插管率和活检率表明，应用包括肠道准备和全身麻醉的套餐并进一步集中操作流程后，儿科结肠镜检查质量得到改善。
