优质护理在鼻窦炎鼻息肉患者鼻内镜手术中的疗效及术后并发症发生率分析

分析优质护理在鼻窦炎鼻息肉患者鼻内镜手术中的疗效及术后并发症发生率。方法 选择2021年1月至2022年12月期间在医疗机构接受鼻内镜手术的鼻窦炎鼻息肉患者共100例。随机分为两组,对照组采取常规护理,观察组应用优质护理,对比护理效果。结果 经过护理后发现,观察组出现并发症概率低于对照组,观察组SF-36评分、PSQI评分及SNOT-20评分优于对照组,观察组血气指标优于对照组,观察组护理满意度高于对照组,P<0.05,差异具有统计学意义。结论 对于鼻窦炎鼻息肉患者鼻内镜手术中采取优质护理,能够有效提升护理干预效果,值得临床推广。

中鼻甲切除对功能性鼻内镜手术临床疗效的研究进展

慢性鼻窦炎是一种常见的鼻科疾病,是指鼻窦与鼻腔黏膜的慢性炎症,病程超过12周,可分为慢性鼻-鼻窦炎不伴鼻息肉及慢性鼻-鼻窦炎伴鼻息肉两型。主要的临床症状包括鼻塞、脓涕、头面部胀痛、嗅觉减退或消失[1]。规范化治疗失败的患者,功能性鼻内镜手术（FESS）是常被选择的治疗方式之一,在各种鼻内镜手术技术中,中鼻甲是否需要保留,始终存在争议。

Long-term outcome and efficacy of endoscopic hemorrhoid ligation for symptomatic internal hemorrhoids

AIM:To assess the long-term outcome of endoscopic hemorrhoid ligation (EHL) for the treatment of symptomatic internal hemorrhoids.METHODS:A total of 759 consecutive patients (415 males and 344 females) were enrolled.Clinical presentations were rectal bleeding (593 patients) and mucosal prolapse (166 patients).All patients received EHL at outpatient clinics.Hemorrhoid severity was classified by Goligher's grading.The mean follow-up period was 55.4 mo (range,45-92 mo).RESULTS:The number of band ligations averaged 2.35 in the first session for bleeding and 2.69 for prolapsed patients.Bleeding was controlled in 587 (98.0%) patients,while prolapse was reduced in 137 (82.5%) patients.After treatment,93 patients experienced anal pain and 48 patients had mild bleeding.Patient subjective satisfaction was 93.6%.Repeat treatment or surgery was performed if symptoms were not relieved in the first session.In the bleeding group,the recurrence rate was 3.7% (22 patients) at 1 year,and 6.6%and 13.0% at 2 and 5 years.In the prolapsed group,the recurrence rate was 3.0%,9.6% and 16.9% at 1,2 and 5 years,respectively.CONCLUSION:EHL is an easy and well-tolerated procedure for the treatment of symptomatic internal hemorrhoids,with good long-term results.

Efficacy of endoscopic therapy for gastrointestinal bleeding from Dieulafoy’s lesion

AIM： To investigate the endoscopic hemostasis for gastrointestinal bleeding due to Dieulafoy＇s lesion. METHODS： One hundred and seven patients with gastrointestinal bleeding due to Dieulafoy＇s lesion were treated with three endoscopic hemostasis methods： aethoxysklerol injection （46 cases）, endoscopic hemoclip hemostasis （31 cases）, and a combination of hemoclip hemostasis with aethoxysklerol injection （30 cases）. RESULTS： The rates of successful hemostasis using the three methods were 71.7% （33/46）, 77.4% （24/31） and 96.7% （29/30）, respectively, with significant differences between the methods （P 〈 0.05）. Among those who had unsuccessful treatment with aethoxysklerol injection, 13 were treated with hemoclip hemostasis and 4 underwent surgical operation; 9 cases were successful in the injection therapy. Among the cases with unsuccessful treatment with hemoclip hemostasis,7 were treated with injection of aethoxysklerol and 3 cases underwent surgical operation; 4 cases were successful in the treatment with hemoclip hemostasis. Only 1 case had unsuccessful treatment with a combined therapy of hemoclip hemostasis and aeth- oxysklerol injection, and surgery was then performed. No serious complications of perforation occurred in the patients whose bleeding was treated with the endoscopic hemostasis, and no releeding was found during a 1-year follow-up. CONCLUSION： The combined therapy of hemoclip hemostasis with aethoxysklerol injection is the most effective method for gastrointestinal bleeding due to Dieulafoy＇s lesion.

内镜下治疗消化道早癌及癌前病变20例临床分析

目的:探讨治疗消化道早癌及癌前病变时选择内镜技术的效果。方法:以2013年2月至2015年2月为期,共挑选患者20例,所有患者均确诊为消化道早癌,并伴有癌前病变,均为其采用内镜下手术治疗模式,记录患者的治疗效果、并发症率。结果:采用内镜黏膜剥离术治疗患者一次切除率为90.91%(10/11),平均手术时间为(80.27±9.03)min,出血率为9.09%(1/11),穿孔率为0%。采用内镜黏膜切除术治疗患者一次切除率为100%(9/9),平均手术时间为(40.19±3.26)min,出血率为11.11%(1/9),穿孔率为11.11%(1/9)。经后续处理后出血和穿孔情况恢复良好,采取为期12个月随访复发率为0%。结论:利用内镜下治疗消化道早癌及癌前病变手术时间较短,术后并发症低,短期内复发率低。