Dai Zhu-Hua, Xu Lu, Yang Yu, He Xu-Ni, Chen Ke
Department of Gastroenterology, Ningbo Yinzhou No. 2 Hospital, Ningbo 315000, Zhejiang Province, China.
World J Clin Cases. 2024 Jul 16;12(20):4034-4040. doi: 10.12998/wjcc.v12.i20.4034.
Endoscopic submucosal dissection (ESD) is a less invasive local treatment for diseases throughout the gastrointestinal tract.
To develop an integrated management protocol and analyze its effects on surgical outcomes and mental health of patients after ESD.
The study population consisted of patients undergoing ESD before implementation of integrated management and those undergoing ESD by the same pool of surgeons after implementation of integrated management.
The management group exhibited shortened fasting time and length of hospital stay compared to the control group ( < 0.05). The management group exhibited a higher incidence rate of postoperative complications than the control group (3 cases 11 cases; = 0.043). The management group exhibited a lower uncertainty score for disease knowledge compared to the control group 12 h after surgery ( < 0.05). The management group gave more scores on the domains of patient familiarity to the responsible nurses, professional skills of responsible nurses, and general evaluation compared to the control group. The management group had a higher total score of patient satisfaction towards the responsible nurses in term of health care than the control group ( < 0.01). The management group exhibited lower Self-Rating Anxiety Scale and Self-Rating Depression Scale scores compared to the control group 12 h after surgery ( < 0.01).
The study demonstrates that integrated management could improve surgical outcomes and mental health of patients undergoing ESD.
内镜黏膜下剥离术（ESD）是一种用于治疗全胃肠道疾病的侵入性较小的局部治疗方法。
制定综合管理方案并分析其对ESD术后患者手术结局及心理健康的影响。
研究人群包括在实施综合管理之前接受ESD的患者以及在实施综合管理之后由同一组外科医生进行ESD治疗的患者。
与对照组相比，管理组的禁食时间和住院时间缩短（P<0.05）。管理组术后并发症发生率高于对照组（3例比11例；P=0.043）。与对照组相比，管理组术后12小时疾病知识的不确定性评分更低（P<0.05）。与对照组相比，管理组在对责任护士的熟悉程度、责任护士的专业技能以及总体评价等方面得分更高。在医疗保健方面，管理组对责任护士的患者满意度总分高于对照组（P<0.01）。与对照组相比，管理组术后12小时的自评焦虑量表和自评抑郁量表得分更低（P<0.01）。
该研究表明综合管理可改善接受ESD治疗患者的手术结局及心理健康。
