目的:探究以护理美学为导向的细节化护理对乳腺癌保乳术患者心理状态和瘢痕的影响。方法:选取2020年6月-2022年8月笔者医院收治的68例预行乳腺癌保乳术的患者,按照随机数字表法分为观察组和对照组各34例。对照组采用常规护理干预,观察...目的:探究以护理美学为导向的细节化护理对乳腺癌保乳术患者心理状态和瘢痕的影响。方法:选取2020年6月-2022年8月笔者医院收治的68例预行乳腺癌保乳术的患者,按照随机数字表法分为观察组和对照组各34例。对照组采用常规护理干预,观察组在对照组基础上采用以护理美学为导向的细节化护理。分析干预前及术后14 d时患者心理状态[简明心境量表(Profile of mood states,POMS)评分]、干预前及术后3个月时生活质量[癌症指标患者生命质量测定表(European organization for research and treatment of cancer quality of life questionnaire,EORTC QLQ-C30)]变化,分析干预后两组术后7 d时睡眠质量[匹茨堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)]、疼痛评分[视觉模拟评分法(Visual analogue scale,VAS)]以及术后1、3个月时瘢痕情况[温哥华瘢痕量表(Vancouver scar scale,VSS)评分]差异。结果:术后14 d时,两组POMS评分较干预前明显改善,且观察组优于对照组(P<0.05);术后3、5、7 d时,观察组VAS评分均低于对照组(P<0.05);术后7 d时,观察组PSQI低于对照组(P<0.05);术后3个月时,两组VSS评分较术后1个月时均降低,且观察组低于对照组(P<0.05),EORTC QLQ-C30评分较干预前升高,且观察组高于对照组(P<0.05)。结论:对乳腺癌保乳术患者实施以护理美学为指导的细节化护理干预,能有效改善患者心理状态,缓解术后疼痛,减少瘢痕形成,提高患者术后生活质量,值得临床推荐。展开更多
AIM To describe a series of patients with aberrant polypoid nodule scar developed after gastric endoscopic submucosal dissection(ESD), and to discuss its pathogenesis and clinical management. METHODS We reviewed retro...AIM To describe a series of patients with aberrant polypoid nodule scar developed after gastric endoscopic submucosal dissection(ESD), and to discuss its pathogenesis and clinical management. METHODS We reviewed retrospectively the endoscopic database of two academic institutions located in Brazil and Japan and searched for all patients that underwent ESD to manage gastric neoplasms from 2003 to 2015. The criteria for admission in the study were:(1) successful en bloc ESD procedure with R0 and curative resection confirmed histologically;(2) postoperative endoscopic examination with identification of a polypoid nodule scar(PNS) at ESD scar;(3) biopsies of the PNS with hyperplastic or regenerative tissue, reviewed by two independent experienced gastrointestinal pathologists, one from each Institution. Data were examined for patient demographics, Helicobacter pylori status, precise neoplastic lesion location in the stomach, tumor size, histopathological assessment of the ESD specimen, and postoperative information including medical management, endoscopic and histological findings, and clinical outcome.RESULTS A total of 14 patients(10 men/4 women) fulfilled the inclusion criteria and were enrolled in this study. One center contributed with 8 cases out of 60 patients(13.3%) from 2008 to 2015. The second center contributed with 6 cases(1.7%) out of 343 patients from 2003 to 2015. Postoperative endoscopic follow-up revealed similar findings in all patients: A protruded polypoid appearing nodule situated in the center of the ESD scar surrounded by convergence of folds. Biopsies samples were taken from PNS, and histological assessment revealed in all cases regenerative and hyperplastic tissue, without recurrent tumor or dysplasia. Primary neoplastic lesions were located in the antrum in 13 patients and in the angle in one patient. PNS did not develop in any patient after ESD undertaken for tumors located in the corpus, fundus or cardia. All patients have been followed systematically on an annual basis and no malignant recurrence in the ESD scar has been identified(mean follow-up period: 45 mo).CONCLUSION PNS may occur after ESD for antral lesions and endoscopically look concerning, especially for the patient or the family doctor. However, as long as curative R0 resection was successfully achieved and histology demonstrates only regenerative and hyperplastic tissue, PNS should be viewed as a benign alteration that does not require any type of intervention, other than endoscopic surveillance.展开更多
文摘目的:探究以护理美学为导向的细节化护理对乳腺癌保乳术患者心理状态和瘢痕的影响。方法:选取2020年6月-2022年8月笔者医院收治的68例预行乳腺癌保乳术的患者,按照随机数字表法分为观察组和对照组各34例。对照组采用常规护理干预,观察组在对照组基础上采用以护理美学为导向的细节化护理。分析干预前及术后14 d时患者心理状态[简明心境量表(Profile of mood states,POMS)评分]、干预前及术后3个月时生活质量[癌症指标患者生命质量测定表(European organization for research and treatment of cancer quality of life questionnaire,EORTC QLQ-C30)]变化,分析干预后两组术后7 d时睡眠质量[匹茨堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)]、疼痛评分[视觉模拟评分法(Visual analogue scale,VAS)]以及术后1、3个月时瘢痕情况[温哥华瘢痕量表(Vancouver scar scale,VSS)评分]差异。结果:术后14 d时,两组POMS评分较干预前明显改善,且观察组优于对照组(P<0.05);术后3、5、7 d时,观察组VAS评分均低于对照组(P<0.05);术后7 d时,观察组PSQI低于对照组(P<0.05);术后3个月时,两组VSS评分较术后1个月时均降低,且观察组低于对照组(P<0.05),EORTC QLQ-C30评分较干预前升高,且观察组高于对照组(P<0.05)。结论:对乳腺癌保乳术患者实施以护理美学为指导的细节化护理干预,能有效改善患者心理状态,缓解术后疼痛,减少瘢痕形成,提高患者术后生活质量,值得临床推荐。
文摘AIM To describe a series of patients with aberrant polypoid nodule scar developed after gastric endoscopic submucosal dissection(ESD), and to discuss its pathogenesis and clinical management. METHODS We reviewed retrospectively the endoscopic database of two academic institutions located in Brazil and Japan and searched for all patients that underwent ESD to manage gastric neoplasms from 2003 to 2015. The criteria for admission in the study were:(1) successful en bloc ESD procedure with R0 and curative resection confirmed histologically;(2) postoperative endoscopic examination with identification of a polypoid nodule scar(PNS) at ESD scar;(3) biopsies of the PNS with hyperplastic or regenerative tissue, reviewed by two independent experienced gastrointestinal pathologists, one from each Institution. Data were examined for patient demographics, Helicobacter pylori status, precise neoplastic lesion location in the stomach, tumor size, histopathological assessment of the ESD specimen, and postoperative information including medical management, endoscopic and histological findings, and clinical outcome.RESULTS A total of 14 patients(10 men/4 women) fulfilled the inclusion criteria and were enrolled in this study. One center contributed with 8 cases out of 60 patients(13.3%) from 2008 to 2015. The second center contributed with 6 cases(1.7%) out of 343 patients from 2003 to 2015. Postoperative endoscopic follow-up revealed similar findings in all patients: A protruded polypoid appearing nodule situated in the center of the ESD scar surrounded by convergence of folds. Biopsies samples were taken from PNS, and histological assessment revealed in all cases regenerative and hyperplastic tissue, without recurrent tumor or dysplasia. Primary neoplastic lesions were located in the antrum in 13 patients and in the angle in one patient. PNS did not develop in any patient after ESD undertaken for tumors located in the corpus, fundus or cardia. All patients have been followed systematically on an annual basis and no malignant recurrence in the ESD scar has been identified(mean follow-up period: 45 mo).CONCLUSION PNS may occur after ESD for antral lesions and endoscopically look concerning, especially for the patient or the family doctor. However, as long as curative R0 resection was successfully achieved and histology demonstrates only regenerative and hyperplastic tissue, PNS should be viewed as a benign alteration that does not require any type of intervention, other than endoscopic surveillance.
