Newcomer M K, Brazer S R
Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Gastrointest Endosc Clin N Am. 1994 Jul;4(3):551-70.
The tremendous growth in the use of gastrointestinal endoscopy has necessarily produced complications of the procedures. In general, overall reported complication rates for diagnostic endoscopy are extremely low (0.13%-0.24%) reflecting these procedures' overall safety. However, many of these reports are likely to underestimate the true complication rate. Therapeutic procedures have substantially higher complication rates, the most frequent of which is perforation. Esophageal dilation, achalasia pneumatic dilation, and esophageal endoprosthesis placement carry the highest risk of perforation, 0.25%, 3.3%, and 7% to 15%, respectively. The outcomes research movement will revolutionize the future practice of endoscopy. Practice guidelines for endoscopy will not be determined by expert panels, but will be established empirically by outcomes research. Accurate complication rates will be determined from studies with complete and timely collection of intervention, confounding factors, and outcome. Finally, risk factors will be established by studies of appropriate design and power.
胃肠道内镜检查使用的迅猛增长必然带来了该检查程序的并发症。总体而言，诊断性内镜检查报告的总体并发症发生率极低（0.13%-0.24%），这反映了这些检查程序的总体安全性。然而，许多此类报告可能低估了真正的并发症发生率。治疗性检查程序的并发症发生率要高得多，其中最常见的是穿孔。食管扩张、贲门失弛缓症的气囊扩张以及食管内支架置入术的穿孔风险最高，分别为0.25%、3.3%以及7%至15%。结果研究运动将彻底改变内镜检查的未来实践。内镜检查的实践指南将不由专家小组决定，而是通过结果研究凭经验确定。准确的并发症发生率将通过对干预措施、混杂因素和结果进行完整且及时收集的研究来确定。最后，风险因素将通过设计合理且具备足够效力的研究来确定。
