针对性护理对日间肠镜患者焦虑情绪的改善作用分析

目的:探讨日间病房肠镜患者在针对性护理的改善作用分析。方法:选取2024年1~6月,随机抽取我院日间病房肠镜患者100例,采用随机数字表法分为观察组50例与对照组50例。对照组采用常规术后常规护理模式,观察组采用针对性护理模式。结果比较两组负性情绪、SAS、SDS、疼痛感情况,护理后患者舒适度和对于护理的满意情况。结果:护理后,观察组抑郁自评量表、焦虑自评量表评分均低于对照组,差异有统计学意义(P P Objective: This paper aims to explore the improvement of targeted nursing for patients with day-ward colonoscopy. Methods: From January to June 2024, 100 patients with dayward colonoscopy in our hospital were randomly selected and divided into observation group (50 cases) and control group (50 cases) by random number table method. The control group adopted the routine nursing mode, and the observation group adopted the targeted nursing mode. Results: Negative emotion, SAS, SDS, pain perception, comfort and satisfaction of nursing were compared between the two groups. Results: After nursing, the scores of self-rating depression scale and self rating anxiety scale in observation group were lower than those in control group, and the difference was statistically significant (P P < 0.05). Conclusion: The implementation of targeted nursing for patients with day ward colonoscopy can effectively alleviate anxiety and depression, improve nursing satisfaction, and the clinical effect is remarkable.

心理护理在肠镜患者服用泻药后舒适度效果研究

探讨心理护理在肠镜患者服用泻药后舒适度效果 方法 选取南充中心医院在2021年期间就诊的70例肠镜患者为研究对象,采用随机分类法将70例患者分为对照组和观察组,每组各35例患者,对照组患者在肠镜检测准备阶段服用泻药后采用医院常规护理,观察组给予心理护理,对比两组肠镜患者服用泻药后SAS评分及SDS评分、护理满意度、不良反应对比。结果 发现采用心理护理的观察组患者,在SAS评分及SDS评分观察组患者SAS评分及SDS评分都明显低于对照组。在护理满意度方面,观察组患者整体满意度为94%,高于对照组的80%,在不良反应方面也显著低于对照组,差异具有统计学意义(p<0.05)。结论 心理护理在肠镜患者服用泻药后能够提升患者的护理满意度,也能够降低患者的服用泻药后的不良心理反应,缓解患者的心理负担,能够提高肠镜患者服用泻药后舒适度,值得在临床大力推广。

康复干预对肠镜下结肠息肉切除术患者预后效果的影响分析

目的探讨康复干预对肠镜下结肠息肉切除术患者预后效果的影响。方法68例行肠镜下结肠息肉切除术患者,依据信封随机法分为实验组与对照组,每组34例。对照组给予常规干预,实验组在对照组干预的基础上进行康复干预。比较两组术后康复效果、术后住院时间、并发症发生率及干预前后生活质量。结果实验组术后康复总有效率为100.00%,高于对照组的79.41%,差异有统计学意义(P<0.05)。实验组术后住院时间(6.01±0.61)d短于对照组的(8.24±0.65)d,差异有统计学意义(P<0.05)。实验组并发症发生率为2.94%,低于对照组的23.53%,差异有统计学意义(P<0.05)。干预后,实验组生活质量评分(93.56±4.45)分高于对照组的(83.21±4.42)分,差异有统计学意义(P<0.05)。结论康复干预在肠镜下结肠息肉切除术患者的术后干预中应用效果确切,可减少并发症发生,缩短住院时间和提高康复效果,促进患者生活质量改善,值得推广。

Listening to Turkish classical music decreases patients’anxiety,pain,dissatisfaction and the dose of sedative and analgesic drugs during colonoscopy:A prospective randomized controlled trial

AIM： To determine whether listening to music decreases the requirement for dosages of sedative drugs, patients＇ anxiety, pain and dissatisfaction feelings during colonoscopy and makes the procedure more comfortable and acceptable. METHODS： Patients undergoing elective colonoscopy between October 2005 and February 2006 were randomized into either listening to music （Group 1, n = 30） or not listening to music （Group 2, n = 30）. Anxiolytic and analgesic drugs （intravenous midazolam and meperidine） were given according to the patients＇ demand. Administered medications were monitored. We determined their levels of anxiety using the State-Trait Anxiety Inventory Test form. Patients＇ satisfaction, pain, and willingness to undergo a repeated procedure were self-assessed using a visual analog scale. RESULTS： The mean dose of sedative and analgesic drugs used in group 1 （midazolam： 2.1 ± 1.4, meperidine： 18.1 ± 11.7） was smaller than group 2 （midazolam： 2.4 ± 1.0, meperidine： 20.6 ± 11.5）, but without a significant difference （P 〉 0.05）. The mean anxiety level in group 1 was lower than group 2 （36.7 ± 2.2 vs 251.0 ± 1.9, P 〈 0.001）. The mean satisfaction score was higher in group 1 compared to group 2 （87.8 ± 3.1 vs 58.1 ± 3.4, P 〈 0.001）. The mean pain score in group i was lower than group 2 （74.1 ± 4.7 vs 39.0 ± 3.9, P 〈 0.001）. CONCLUSION： Listening to music during colonoscopy helps reduce the dose of sedative medications, as well as patients＇ anxiety, pain, dissatisfaction during the procedure. Therefore, we believe that listening to music can play an adjunctive role to sedation in colonoscopy. It is a simple, inexpensive way to improve patients＇ comfort during the procedure.

Evaluation of Fujinon intelligent chromo endoscopy-assisted capsule endoscopy in patients with obscure gastroenterology bleeding

AIM:To investigate the potential benef it of Fujinon in-telligent chromo endoscopy(FICE)-assisted small bowel capsule endoscopy(SBCE)for detection and character-ization of small bowel lesions in patients with obscure gastroenterology bleeding(OGIB).METHODS:The SBCE examinations(Pillcam SB2,Giv-en Imaging Ltd)were retrospectively analyzed by two GI fellows(observers)with and without FICE enhance-ment.Randomization was such that a fellow did not assess the same examination with and without FICE enhancement.The senior consultant described f indings as P0,P1 and P2 lesions(non-pathological,intermedi-ate bleed potential,high bleed potential),which were considered as reference f indings.Main outcome mea-surements:Inter-observer correlation was calculated using kappa statistics.Sensitivity and specif icity for P2 lesions was calculated for FICE and white light SBCE.RESULTS:In 60 patients,the intra-class kappa cor-relations between the observers and reference f indings were 0.88 and 0.92(P2),0.61 and 0.79(P1),for SBCE using FICE and white light,respectively.Overall 157 le-sions were diagnosed using FICE as compared to 114 with white light SBCE(P = 0.15).For P2 lesions,the sensitivity was 94% vs 97% and specif icity was 95% vs 96% for FICE and white light,respectively.Five(P2 le-sions)out of 55 arterio-venous malformations could be better characterized by FICE as compared to white light SBCE.Significantly more P0 lesions were diagnosed when FICE was used as compared to white light(39 vs 8,P < 0.001).CONCLUSION:FICE was not better than white light for diagnosing and characterizing signif icant lesions on SBCE for OGIB.FICE detected signif icantly more non-pathological lesions.Nevertheless,some vascular le-sions could be more accurately characterized with FICE as compared to white light SBCE.

Carbon dioxide insufflation during colonoscopy in deeply sedated patients

AIM:To compare the impact of carbon dioxide(CO2) and air insufflation on patient tolerance/safety in deeply sedated patients undergoing colonoscopy.METHODS:Patients referred for colonoscopy were randomized to receive either CO2 or air insufflation during the procedure.Both the colonoscopist and patient were blinded to the type of gas used.During the procedure,insertion and withdrawal times,caecal intubationrates,total sedation given and capnography readings were recorded.The level of sedation and magnitude of patient discomfort during the procedure was assessed by a nurse using a visual analogue scale(VAS)(0-3).Patients then graded their level of discomfort and abdominal bloating using a similar VAS.Complications during and after the procedure were recorded.RESULTS:A total of 142 patients were randomized with 72 in the air arm and 70 in the CO2 arm.Mean age between the two study groups were similar.Insertion time to the caecum was quicker in the CO2 group at 7.3 min vs 9.9 min with air(P = 0.0083).The average withdrawal times were not significantly different between the two groups.Caecal intubation rates were 94.4% and 100% in the air and CO2 groups respectively(P = 0.012).The level of discomfort assessed by the nurse was 0.69(air) and 0.39(CO2)(P = 0.0155) and by the patient 0.82(air) and 0.46(CO2)(P = 0.0228).The level of abdominal bloating was 0.97(air) and 0.36(CO2)(P = 0.001).Capnography readings trended to be higher in the CO2 group at the commencement,caecal intubation,and conclusion of the procedure,even though this was not significantly different when compared to readings obtained during air insufflation.There were no complications in both arms.CONCLUSION:CO2 insufflation during colonoscopy is more efficacious than air,allowing quicker and better cecal intubation rates.Abdominal discomfort and bloating were significantly less with CO2 insufflation.

Virtual colonoscopy-induced perforation in a patient with Crohn's disease

We report a case of sigmoid colon perforation in a patient with Crohn's disease undergoing computed-tomographic (CT) colonography. A 70-year-old patient with Crohn's disease with terminal ileitis and sigmoid stricture underwent CT colonography after incomplete conventional colonoscopy. During the procedure, the colon was inflated by air insufflation and the patient developed abdominal pain with radiological evidence of retroperitoneal and intraperitoneal free gas. Hartmann's operation was performed. This case highlights that CT colonography is not risk-free. The risk of perforation may be higher in patients with inflammatory bowel disease.

Double-balloon-enteroscopy-based endoscopic retrograde cholangiopancreatography in post-surgical patients

AIM: To evaluate double balloon enteroscopy (DBE) in post-surgical patients to perform endoscopic retrograde cholangiopancreatography (ERCP) and interventions. METHODS: In 37 post-surgical patients, a stepwise approach was performed to reach normal papilla or enteral anastomoses of the biliary tract/pancreas. When conventional endoscopy failed, DBE-based ERCP was performed and standard parameters for DBE, ERCP and interventions were recorded. RESULTS: Push-enteroscopy (overall, 16 procedures) reached enteral anastomoses only in six out of 37 post-surgical patients (16.2%). DBE achieved a high rate of luminal access to the biliary tract in 23 of the remaining 31 patients (74.1%) and to the pancreatic duct (three patients). Among all DBE-based ERCPs (86 procedures), 21/23 patients (91.3%) were successfully treated. Interventions included ostium incision or papillotomy in 6/23 (26%) and 7/23 patients (30.4%), respectively. Biliary endoprosthesis insertion and regular exchange was achieved in 17/23 (73.9%) and 7/23 patients (30.4%), respectively. Furthermore, bile duct stone extraction as well as ostium and papillary dilation were performed in 5/23 (21.7%) and 3/23 patients (13.0%), respectively. Complications during DBE-based procedures were bleeding (1.1%), perforation (2.3%) and pancreatitis (2.3%), and minor complications occurred in up to 19.1%. CONCLUSION: The appropriate use of DBE yields a high rate of luminal access to papilla or enteral anastomoses in more than two-thirds of post-surgical patients, allowing important successful endoscopic therapeutic interventions.