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世界核心医学期刊文摘（胃肠病学分册） 2005年第7期1卷 20-21页

作者： Denis B. Weiss A.- m. Peter A. 翟惠虹 Service de médecine A Hpitaux Civils 68024 Colmar Cedex France

The aim of this study was to assess the quality of colonoscopic procedures in our endoscopy unit with the goal of improving performance. methods - We prospe ctively audited 500 consecutive colonoscopic procedures and assessed sixty- two process or outcome indicators for each procedure. Results - most of the measu red indicators were within standard limits: cecal intubation rate (92% ), inade quate bowel preparations (24% ) , inappropriate procedures (9.7% ), normal pro cedures (54% ), yield for neoplasia (32% ), morbidity (0.4% ), and overall pa tient satisfaction (95.8% ). Some indicators were outside standard limits sugge sting our practices should be modified: endoscopy withdrawal time less than 6 mi nutes (78% ), forceps removal of polyps (31% ), resected polyps not recovered for pathological examination (12% ), adenomas with villous elements (22% ) , p atients unsatisfied because of time spent waiting for the procedure (19% ), pat ients unsatisfied because of inadequate explanations (10% ). There was no stand ard for a few indicators: patient discomfort (6.9% ), diagnostic success (89% ), therapeutic success (92% ). Three new indicators were proposed: proportion of patients aged m ber of normal colonoscopic procedures to perform to detect one advanced adenoma or cancer, and proportion of colonoscopic procedures causing discomfort. The dia gnostic yield of colonoscopy was dependent on age, gender, indication and approp riateness of indication but not on the prescriber. Conclusion- This audit allow ed us to evaluate our endoscopic practices and to detect certain shortcomings an d deviations from standards. It enabled us to change some or our practices with the goal of improving the quality of our colonoscopic procedures.

关键词：结肠镜检内镜检查预示因素内镜操作内镜诊疗钳取肠道准备并发症发病率进展期腺瘤发现率

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