Application of "EndoAngel"-assisted colonoscopy in the detection rate of colorectal polyps
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摘要:
目的 探讨“内镜精灵”辅助结肠镜检查在结肠息肉检查中的应用价值，为医疗工作者诊断和筛查结肠息肉提供一定的参考。 方法 选取2023年8月—2024年3月在襄阳市第一人民医院接受结肠镜检查的1 080例患者，使用随机数字表法分为对照组(540例)和试验组(540例)。对照组由常规内镜护士联合内镜医生在结肠镜检查中共同观察，试验组由“内镜精灵”辅助结肠镜检查进行实时监测。主要结局指标为结肠息肉的检出率(PDR)，次要结局指标包括结肠息肉的大小、息肉单发或多发、肠道准备质量以及检出结肠腺瘤的灵敏度和特异度。 结果 试验组PDR[24.07%(130/540) vs. 15.56%(84/540)]高于对照组，差异有统计学意义(χ2=12.331，P<0.001)。2组肠道准备质量情况比较，差异无统计学意义(P>0.05)。2组息肉大小检出情况比较，差异有统计学意义(P<0.05)，相较于对照组，试验组在小息肉及微小息肉检出上更有优势；2组息肉数量检出情况比较，差异有统计学意义(P<0.05)。在180例接受病理学检验的患者中，试验组特异度和灵敏度均高于对照组，差异有统计学意义(P<0.05)。 结论 “内镜精灵”辅助结肠镜检查在提高结肠息肉检出率方面具有显著优势，尤其是微小息肉及多发息肉，从而能够更早地对结直肠癌进行预防和治疗。 Abstract:Objective To explore the application value of "EndoAngel" assisted colonoscopy in the examination of colon polyps, and to provide some reference for medical workers in the diagnosis and screening of colon polyps. Methods A total of 1 080 patients undergoing colonoscopy at the Endoscopy Center of Xiangyang No.1 People ' s Hospital from August 2023 to March 2024 were randomly assigned into the control group (n=540) and the experimental group (n=540) using a random number table. The control group underwent conventional colonoscopy with observations jointly performed by endoscopy nurses and endoscopists, while the experimental group utilized real-time monitoring with "EndoAngelⓇ" assisted colonoscopy. The primary outcome measure was the polyp detection rate (PDR), while secondary outcomes included polyp size, single or multiple polyps, bowel preparation quality, as well as the sensitivity and specificity for detecting colorectal adenomas. Results The PDR of the experimental group [24.07% (130/540) vs. 15.56% (84/540)] was higher than that of the control group (χ2=12.331, P<0.001). There was no statistically significant difference in the quality of intestinal preparation between the two groups (P>0.05). The difference in polyp size detection between the two groups was statistically significant (P<0.05). Compared with the control group, the experimental group had an advantage in detecting small and micro polyps; The difference in the number of polyps detected between the two groups was statistically significant (P<0.05). Among 180 patients who underwent pathological examination, the experimental group had higher specificity and sensitivity than the control group (P<0.05). Conclusion Real-time monitoring by "EndoAngelⓇ" assisted colonoscopy has significant advantages in improving the detection rate of colonic polyps, especially small polyps, and multiple polyps, which can prevent and treat colorectal cancer earlier. -
Key words:
- Colorectal polyps /
- Colonoscopy /
- Artificial intelligence
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表 1 2组结肠镜检查患者基线资料比较
Table 1. Comparison of baseline data between the two groups of patients undergoing colonoscopy
项目 对照组(n=540) 试验组(n=540) 统计量 P值 年龄(x±s，岁) 44.99±7.25 45.32±7.71 0.725a 0.469 性别[例(%)] 0.626b 0.429 男性 274(50.74) 260(48.15) 女性 266(49.26) 280(51.85) BMI(x±s) 25.99±1.41 25.93±1.39 0.704a 0.481 民族[例(%)] 0.817b 0.366 汉族 520 (96.30) 514(95.19) 少数民族 20 (3.70) 26(4.81) 文化程度[例(%)] 1.607c 0.108 初中及以下 81 (15.00) 96(17.78) 高中或中专 139 (25.74) 150(27.78) 大专或大学本科 255 (47.22) 235(43.52) 研究生及以上 65 (12.04) 59(10.92) 饮酒史[例(%)] 0.071b 0.789 否 465(86.11) 469(86.85) 是 75(13.89) 71(13.15) 吸烟史[例(%)] 0.421b 0.517 否 369(68.33) 358(66.30) 是 171(31.67) 182(33.70) 注：a为t值，b为χ2值，c为Z值。 
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表 2 2组结肠镜检察患者结直肠息肉检出情况比较[例(%)]
Table 2. Comparison of colorectal polyps detected by colonoscopy between the two groups [cases (%)]
项目 对照组
(n=84)试验组
(n=130)统计量 P值 息肉大小 2.774a 0.006 微小息肉(0~5 mm) 16(19.05) 30(23.08) 小息肉(6~9 mm) 30(35.71) 71(54.62) 大息肉(≥10 mm) 38(45.24) 29(22.31) 息肉数量 4.014b 0.045 单发(1个) 44(52.38) 50(38.46) 多发(≥2个) 40(47.62) 80(61.54) 肠道准备质量 0.943a 0.346 较差(BBPS 0~5分) 7(8.33) 15(11.54) 合格(BBPS 6~7分) 61(72.62) 95(73.08) 优秀(BBPS 8~9分) 16(19.05) 20(15.38) 注：a为Z值，b为χ2值。
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表 3 2组结直肠息肉患者结直肠腺瘤诊断效能比较(%)
Table 3. Comparison of diagnostic efficacy of colorectal adenoma in patients with colorectal polyps in two groups (%)
组别 例数 灵敏度 特异度 对照组 52 71.15(37/52) 64.10(25/39) 试验组 56 87.50(49/56) 88.89(24/27) χ2值 4.441 5.126 P值 0.035 0.024
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