Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderl...Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderly GP patients admitted between June 2021 and December 2022 were selected.Patients were randomly divided into two groups:the painless group(50 cases)underwent high-frequency electrosurgical knife surgery guided by PDE,while the conventional group(50 cases)underwent the same surgery guided by traditional digestive endoscopy(DE).The total treatment efficacy,perioperative indicators,gastrointestinal hormone levels,oxidative stress(OS)markers,and complication rates were compared between the two groups.Results:The total treatment efficacy in the painless group was higher than that in the conventional group,and perioperative indicators were superior in the painless group(P<0.05).One week after treatment,the gastrointestinal hormone levels and OS-related markers in the painless group were better than those in the conventional group(P<0.05).The complication rate in the painless group was lower than in the conventional group(P<0.05).Conclusion:High-frequency electrosurgical knife surgery guided by PDE improves the effectiveness of polyp removal in elderly GP patients and accelerates postoperative recovery.It also protects gastrointestinal function,reduces postoperative OS,and ensures higher surgical safety.展开更多
AIM:To assess the adoption of Carbon dioxide(CO2)insufflation by endoscopists from various European countries,and its determinants.METHODS:A survey was distributed to 580 endoscopists attending a live course on digest...AIM:To assess the adoption of Carbon dioxide(CO2)insufflation by endoscopists from various European countries,and its determinants.METHODS:A survey was distributed to 580 endoscopists attending a live course on digestive endoscopy.RESULTS:The response rate was 24.5%.Fewer than half the respondents(66/142,46.5%)were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy,and 4.2%of respondents were actually using CO2 as the insufflation agent.Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice(84%and 49%of answers,respectively;two answers were permitted for this item).CONCLUSION:Based on this survey,adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional.A majority of endoscopists were not aware of this possibility,while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.展开更多
BACKGROUND As lifestyles continue to change worldwide,the incidence of digestive tract carcinoma has gradually increased.Digestive endoscopy is an important tool that can assist in the diagnosis,treatment,and surgical...BACKGROUND As lifestyles continue to change worldwide,the incidence of digestive tract carcinoma has gradually increased.Digestive endoscopy is an important tool that can assist in the diagnosis,treatment,and surgical intervention for this disease.However,the examination process is affected by many factors,and patient cooperation is often poor,which can increase the risk of complications.AIM To explore the effects of integrated management and cognitive intervention on cooperation and complications in patients undergoing endoscopy for early gastrointestinal neoplasms.METHODS A total of 354 patients with early stage gastrointestinal cancer who underwent digestive endoscopy procedures between January and December 2023 at our hospital were divided into observation and control groups(177 patients in each group)in a randomized controlled blind trial.The control group received routine interventions,while the observation group received comprehensive integrated management combined with cognitive interventions.We compared the changes in adverse mood,discomfort,examination time,cooperation with the examination,and complications before and after the intervention between the two groups.RESULTS The self-rated anxiety and depression scale scores were lower in the observation group than in the control group(P<0.05).The visual analog scale scores for discomfort during intubation and examination were also lower in the observation group than in the control group(P<0.05).Furthermore,the examination time was shorter in the observation group than in the control group(P<0.05),and the degree of cooperation(94.35%)was higher in the observation group than in the control group(84.75%;P<0.05).Lastly,the incidence rates of gastrointestinal adverse reactions(10.17%vs 20.34%),choking agitation(14.69%vs 24.86%),abdominal pain(8.47%vs 18.08%),and muscle tension(5.08%vs 14.12%)were all lower in the observation group than in the control group(P<0.05).CONCLUSION Integrated management and cognitive intervention in early gastrointestinal neoplasm endoscopy alleviate mood,reduce discomfort,shorten examinations,improve cooperation,and reduce complications.展开更多
<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It ...<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It represents one of the most common pathological entities in</span> gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP).<b> Materials and Method: </b>This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy <span>unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) re</span>ports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. <b>Results: </b>The reports of 593 patients were analyzed. The mean age was 45 years </span></span></span><span><span><span style="font-family:;" "="">old </span></span></span><span><span><span style="font-family:;" "="">(range 8 - 88 years</span></span></span><span><span><span style="font-family:;" "=""> old</span></span></span><span><span><span style="font-family:;" "="">) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of <span>cases. The endoscopic appearance was normal in 229 patients (39%). The</span> endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). <i>H</i>. <i>pylori</i> was present in 404 patients (68%).<b> Conclusion: </b>Gastritis is </span></span></span><span><span><span style="font-family:;" "="">usually</span></span></span><span><span><span style="font-family:;" "=""> found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.</span></span></span>展开更多
<strong>Background:</strong><span><span><span style="font-family:;" "=""> Endoscopy remains the most performant medical exam exploring the upper digestive tract;b...<strong>Background:</strong><span><span><span style="font-family:;" "=""> Endoscopy remains the most performant medical exam exploring the upper digestive tract;but depending on patients, its tolerance is variable.<b> Objective: </b>This study aimed at describing the experience and evaluating the tolerance, acceptability and injuries observed during upper gastrointestinal endoscopy. <b>Methods:</b> This is a prospective and descriptive study carried out from April to July 2017 in the digestive endoscopy unit of the Kara teaching hospital</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(Togo). The gastroscopy was performed by the same operator (Hepatogastroenteroloogist). The premedication was done with direct intravenous injection of 10 mg of Metoclopramide hydrochloride and viscous Lidocaine oral gel. Previously, essential information about the examination course was given to patients after obtaining their verbal consent. Patients’ impressions of the experience, tolerance and acceptability were collected on a survey sheet, before and after the examination.<b> Results:</b> One hundred and eleven patients were included, 62 women and 49 men. The average age was 45.9 years (15</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">88 years), and the sex ratio</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(F/M) was 1.2. Most of the patients (89.2%) were experiencing the gastroscopy for the first time, and the main reason was epigastralgia in 55%. The examination duration was good at 88.3% and tolerance was good at 72.1%. Tingling, irritation, pain or sore throat feelings were noted in 13.5%. Patients agreeing to make an ulterior UDE if necessary were up to 92.8%. Observed injuries were dominated by antral erythematous gastropathy (28.8%).</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Conclusion:</span></b></span></span><span><span><span style="font-family:;" "=""> UDE is well tolerated among our patients and its acceptability is high. Injuries are dominated by inflammatory pathologies of the stomach in our population.</span></span></span>展开更多
<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospita...<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of <i>H. pylori</i> infection. <b>Material and Methods:</b> This is a retrospective, descriptive and analytical study, ranging from the 16<sup>th</sup> of December 2014 to the 16<sup>th</sup> of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. <b>Results:</b> fifty-five percent of these patients were women.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">66% of the patients were under 50</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">years of age. Their major symptom was epigastric pain</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(89.2%),</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">the most observed endoscopic lesion was erythematous gastritis</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(82%) therefore we have noticed 21</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span><span><span><span style="font-family:;" "="">5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, <i>NSAID</i> and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). <i>Helicobacter pylori</i> gastritis was the most frequent (61.30%) and</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><i><span style="font-family:;" "="">Helicobacter pylori</span></i></span></span><span><span><span style="font-family:;" "=""> were present in 63% of gastric biopsies. <b>Conclusion: </b>Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.</span></span></span>展开更多
Objective: this study mainly studies the treatment of patients with intestinal polyps, and conducts the treatment process under the control of gastrointestinal endoscopy, in order to improve the treatment effect of th...Objective: this study mainly studies the treatment of patients with intestinal polyps, and conducts the treatment process under the control of gastrointestinal endoscopy, in order to improve the treatment effect of these patients, shorten the treatment time and recovery time of the patients, and improve the life of the patients. quality. Methods: This study selected 72 patients with intestinal polyps who came to our hospital from November 2020 to January 2022. All patients received intestinal polyp treatment as part of gastrointestinal endoscopy. In order to observe the research results, the selected patients were compared and examined in order to better observe the research results. During the examination of all selected patients, the nursing effect and the occurrence of adverse events should be carefully recorded and compared. At the same time, before nursing the selected patients, professional medical staff will evaluate the overall condition of the patients to ensure that the patients can cooperate in the process of this study, and then they can be included in the study. Patients should also take the initiative to inform patients of the research content and purpose, and the research results can be published only with the consent of patients. Results: two different nursing methods had different effects on selected patients, but relatively high-quality nursing methods were preferred by patients, which minimized adverse reactions during the patient's recovery. There were differences in the results across all patients, which better support the data from this study.展开更多
Objective To explore the application of digestive endoscopy in the treatment of upper gastrointestinal bleeding. Methods Fifty patients in our hospital from July 2017 to July 2022 were randomly divided into two groups...Objective To explore the application of digestive endoscopy in the treatment of upper gastrointestinal bleeding. Methods Fifty patients in our hospital from July 2017 to July 2022 were randomly divided into two groups, 25 patients in each group. The curative effects of the two groups were compared by conventional drug therapy and digestive endoscopy therapy. Results Compared with the control group, the observation group had higher curative effect and lower other indexes (P0.05). Conclusion: the common disease in digestive department is upper gastrointestinal bleeding, the main cause of which is peptic ulcer. The main inducing factors of this disease are Hp infection and the use of non-steroidal anti-inflammatory drugs. The correct treatment depends on reliable evaluation, solid professional skills of clinicians and appropriate intervention. With the clinical application of endoscopic hemostasis, antacids and eradication of Hp, the effective rate of treatment of this disease has been greatly increased, but despite this, the morbidity and mortality of this disease have only increased. At present, clinical practice shows that endoscopic treatment has become the main treatment for gastrointestinal bleeding caused by non-varicose veins. If the volume of body fluid is normal, the hemodynamic stability is stable, and gastroscopy treatment is performed within 24 hours, and the diagnosis evidence can be made clear so that patients can be treated clearly. Before endoscopic examination, proton pump inhibitor was given to reduce the bleeding rate and the need for endoscopic therapy, but it had low influence on rebleeding rate, mortality and surgical operation, and reduced rebleeding rate. For high-risk patients, endoscopic treatment can prevent postoperative rebleeding, and can also reduce the need for later intervention, mortality and other indicators.展开更多
Objective: to explore the effect of risk management in digestive endoscopy room. Methods: 100 patients who were diagnosed and treated in digestive endoscopy room from November 2019 to November 2020 were studied. Compu...Objective: to explore the effect of risk management in digestive endoscopy room. Methods: 100 patients who were diagnosed and treated in digestive endoscopy room from November 2019 to November 2020 were studied. Computer numerical table method is divided into control group (routine basic nursing) 50 cases and management group (risk management nursing) 50 cases. Record the nursing quality and satisfaction of the control group and the management group, and the proportion of adverse events in each group. Results: the nursing satisfaction of the patients in the management group was higher than that of the control group, and the incidence of adverse events in the management group was lower than that of the control group. The difference was statistically significant (P < 0.05). Conclusion: the application of risk management in digestive endoscopy room has obvious effect, reducing the occurrence of adverse events in the process of diagnosis and treatment of patients, and improving the satisfaction and compliance of nursing care. It can be used for the treatment of diseases and is suitable for clinical application.展开更多
Objective: in the process of diagnosis and treatment of digestive endoscopy, different nursing schemes are adopted to summarize and explore the implementation effect of comfort nursing scheme and the improvement of pa...Objective: in the process of diagnosis and treatment of digestive endoscopy, different nursing schemes are adopted to summarize and explore the implementation effect of comfort nursing scheme and the improvement of patient comfort and negative reaction. Methods: from January 20 to January 21, 92 cases were included in our hospital for digestive endoscopy diagnosis and treatment. They were divided into two groups according to the nursing mode. The number of cases included was 46. According to the nursing means, it is named as routine nursing group and comfort nursing group. In the nursing process, the nursing scheme adopted by the routine nursing group for patients is traditional routine nursing, and the nursing scheme adopted by the comfort nursing group for patients is comfort nursing intervention. Summarize and explore the effect of nursing implementation. Results: (1) after comparison, the score of comfort nursing in the routine group was lower and that in the comfort nursing group was higher. There was significant difference between the two groups (P < 0.05). (2) By comparison, the incidence of adverse reactions was higher in the routine nursing group and lower in the comfortable nursing group (P < 0.05). (3) By comparison, the recovery time of gastrointestinal function was longer in the routine nursing group and shorter in the comfort nursing group (P < 0.05). Conclusion: in the process of gastrointestinal endoscopy diagnosis and treatment, combined with comfort nursing intervention can improve the quality of nursing. This scheme is worthy of clinical application and popularization.展开更多
Digestive endoscopy is a special optical instrument for medical diagnosis, which is mainly used to probe the endoscope into the digestive tract of patients to observe whether there are abnormalities or pathological ch...Digestive endoscopy is a special optical instrument for medical diagnosis, which is mainly used to probe the endoscope into the digestive tract of patients to observe whether there are abnormalities or pathological changes. Because of its own rapidity and intuition, digestive endoscopy has been unanimously approved by medical staff and patients, and has also been more widely used in clinical medicine. With the change of lifestyle, more and more people suffer from diseases in the digestive tract. In order to achieve effective treatment and provide a more scientific basis for the operation, medical personnel must have an understanding of the actual disease situation of patients and accurately grasp the pathological changes of patients. This is also the main advantage of digestive endoscopy. In order to provide more safety guarantee for patients, the personnel using the digestive endoscope must have an understanding of the use method and basic structure of the digestive endoscope, be able to accurately judge the problems occurring in the use process of the digestive endoscope, carefully maintain and reduce the occurrence of faults, enable the equipment to have a longer use time, reduce the equipment maintenance consumption and maintain the normal operation of the hospital.展开更多
Objective: to explore the effect of seamless nursing quality management in the diagnosis and treatment of patients with digestive endoscopy. Methods: from February 2020 to February 2021, 114 patients with digestive en...Objective: to explore the effect of seamless nursing quality management in the diagnosis and treatment of patients with digestive endoscopy. Methods: from February 2020 to February 2021, 114 patients with digestive endoscopy received by our hospital were randomly selected for the RCT study, and randomly divided into project group and preset group (general nursing), and the nursing effects of the two groups were compared. Results: compared with the preset group, the incidence of complications in the project group was lower, and the nursing compliance and nursing satisfaction were higher, with statistical significance between the two groups (P < 0.05). Conclusion: the application of seamless nursing quality management in patients with digestive endoscopy can reduce the risk of complications, improve nursing compliance and nursing satisfaction, and is suitable for clinical promotion.展开更多
Objective: to explore the effect of psychological intervention combined with detailed nursing on stress response and examination cooperation degree of patients undergoing digestive endoscopy. Methods: 206 patients und...Objective: to explore the effect of psychological intervention combined with detailed nursing on stress response and examination cooperation degree of patients undergoing digestive endoscopy. Methods: 206 patients undergoing digestive endoscopy in our hospital from March 2021 to December 2021 were selected as the research objects, and divided into control group and observation group according to the principle of comparability of basic characteristics between groups, with 103 cases in each group. The control group received routine nursing while the observation group received psychological intervention combined with detailed nursing. The stress response, psychological state and cooperation degree of the two groups were compared. Results: after psychological intervention combined with detailed nursing intervention, the heart rate, systolic blood pressure and diastolic blood pressure of patients in the observation group were significantly lower than those in the control group 5 minutes before endoscopic examination (P < 0.05). The heart rate and systolic blood pressure of the observation group were significantly lower than those of the control group 5 minutes after the examination (P<0.05). Before psychological intervention combined with detailed nursing, there was no significant difference in SAS and SDS scores between the two groups (P > 0.05). 6 hours after the intervention, the SAS and SDS scores of the observation group were significantly lower than those of the control group (P<0.05). The overall coordination degree of the observation group was significantly higher than that of the control group (P<0.05). Conclusion psychological intervention combined with detailed nursing can significantly reduce patients' stress reaction, improve patients' cooperation degree, and relieve patients' anxiety and depression.展开更多
Background:China has made significant progress in medical accessibility and quality over the past decades,and quality improvements in gastroenterology and digestive endoscopy have been consistent.The study aimed to de...Background:China has made significant progress in medical accessibility and quality over the past decades,and quality improvements in gastroenterology and digestive endoscopy have been consistent.The study aimed to describe the status quo of gastroenterology and digestive endoscopy in the Chinese mainland based on the data from the National Clinical Improvement System(NCIS)and the Hospital Quality Monitoring System(HQMS).Methods:Data were extracted from the NCIS and the HQMS.Data analysis included general information from the Department of Gastroenterology and Endoscopy centers,management of inpatients and outpatients,and annual volume and quality indicators of digestive endoscopy.Acute pancreatitis,gastrointestinal bleeding,inflammatory bowel disease,and cirrhosis were identified as priority diseases and were subjected to detailed analysis.Results:Data from 4620 and 7074 hospitals were extracted from the NCIS and HQMS,respectively.In 2023,9.6 gastroenterologists,6.7 endoscopists,and 37.3 gastroenterology beds per hospital nationwide were observed,achieving 19,252.4 outpatient visits,1615.2 hospitalizations(97.0 for acute pancreatitis,146.1 for gastrointestinal bleeding,40.2 for inflammatory bowel disease,and 111.4 for cirrhosis),and 9432.7 digestive endoscopic procedures per hospital.Overall,the quality of practice improved significantly.The proportion of early cancer among gastrointestinal cancers increased from 11.1%in 2015 to 23.4%in 2023,and the adenoma detection rate during colonoscopy increased from 19.3%in 2019 to 26.9%in 2023.Regarding priority diseases,hospitalizations increased,and 31-day unplanned readmission rates decreased between 2019 and 2023.The median hospitalization costs and median proportion of medication costs decreased for acute pancreatitis,gastrointestinal bleeding,and cirrhosis.However,it increased for inflammatory bowel disease.Conclusion:This report evaluates the status quo and development of gastroenterology and digestive endoscopy in the Chinese mainland,providing guidance for future quality improvements.展开更多
BACKGROUND Propofol is commonly used for sedation during endoscopic procedures.Data suggests its superiority to traditional sedatives used in endoscopy including benzodiazepines and opioids with more rapid onset of ac...BACKGROUND Propofol is commonly used for sedation during endoscopic procedures.Data suggests its superiority to traditional sedatives used in endoscopy including benzodiazepines and opioids with more rapid onset of action and improved postprocedure recovery times for patients.However,Propofol requires administration by trained healthcare providers,has a narrow therapeutic index,lacks an antidote and increases risks of cardio-pulmonary complications.AIM To compare,through a systematic review of the literature and meta-analysis,sedation with propofol to traditional sedatives with or without propofol during endoscopic procedures.METHODS A literature search was performed using MEDLINE,Scopus,EMBASE,the Cochrane Library,Scopus,LILACS,BVS,Cochrane Central Register of Controlled Trials,and The Cumulative Index to Nursing and Allied Health Literature databases.The last search in the literature was performed on March,2019 with no restriction regarding the idiom or the year of publication.Only randomized clinical trials with full texts published were included.We divided sedation therapies to the following groups:(1)Propofol versus benzodiazepines and/or opiate sedatives;(2)Propofol versus Propofol with benzodiazepine and/or opioids;and(3)Propofol with adjunctive benzodiazepine and opioid versus benzodiazepine and opioid.The following outcomes were addressed:Adverse events,patient satisfaction with type of sedation,endoscopists satisfaction with sedation administered,dose of propofol administered and time to recovery post procedure.Meta-analysis was performed using RevMan5 software version 5.39.RESULTS A total of 23 clinical trials were included(n=3854)from the initial search of 6410 articles.For Group I(Propofol vs benzodiazepine and/or opioids):The incidence of bradycardia was not statistically different between both sedation arms(RD:-0.01,95%CI:-0.03–+0.01,I2:22%).In 10 studies,the incidence of hypotension was not statistically difference between sedation arms(RD:0.01,95%CI:-0.02–+0.04,I2:0%).Oxygen desaturation was higher in the propofol group but not statistically different between groups(RD:-0.03,95%CI:-0.06–+0.00,I2:25%).Patients were more satisfied with their sedation in the benzodiazepine+opioid group compared to those with monotherapy propofol sedation(MD:+0.89,95%CI:+0.62–+1.17,I2:39%).The recovery time after the procedure showed high heterogeneity even after outlier withdrawal,there was no statistical difference between both arms(MD:-15.15,95%CI:-31.85–+1.56,I2:99%).For Group II(Propofol vs propofol with benzodiazepine and/or opioids):Bradycardia had a tendency to occur in the Propofol group with benzodiazepine and/or opioidassociated(RD:-0.08,95%CI:-0.13–-0.02,I2:59%).There was no statistical difference in the incidence of bradycardia(RD:-0.00,95%CI:-0.08–+0.08,I2:85%),desaturation(RD:-0.00,95%CI:-0.03–+0.02,I2:44%)or recovery time(MD:-2.04,95%CI:-6.96–+2.88,I2:97%)between sedation arms.The total dose of propofol was higher in the propofol group with benzodiazepine and/or opiates but with high heterogeneity.(MD:70.36,95%CI:+53.11–+87.60,I2:61%).For Group III(Propofol with benzodiazepine and opioid vs benzodiazepine and opioid):Bradycardia and hypotension was not statistically significant between groups(RD:-0.00,95%CI:-0.002–+0.02,I2:3%;RD:0.04,95%CI:-0.05–+0.13,I2:77%).Desaturation was evaluated in two articles and was higher in the propofol+benzodiazepine+opioid group,but with high heterogeneity(RD:0.15,95%CI:0.08–+0.22,I2:95%).CONCLUSION This meta-analysis suggests that the use of propofol alone or in combination with traditional adjunctive sedatives is safe and does not result in an increase in negative outcomes in patients undergoing endoscopic procedures.展开更多
Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome...Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.展开更多
Objective: to explore the clinical effect of upper digestive system hemorrhage under gastrointestinal endoscopy. Methods: the 100 patients with massive upper digestive system bleeding hospitalized from February 2018 t...Objective: to explore the clinical effect of upper digestive system hemorrhage under gastrointestinal endoscopy. Methods: the 100 patients with massive upper digestive system bleeding hospitalized from February 2018 to September 2020 were divided into two groups according to the treatment plan, 50 patients underwent gastroscopy, 50 patients received traditional hemostasis, and the results were compared with the time of hemostasis treatment. Results: comparing the efficacy of the two methods, the hemostasis visualization efficiency of 50 patients was 96% compared to 78%;the bleeding duration (0.87 + 0.35) d, admission days (3.4) d;1.89 + 1.12 d in treatment group, 5.8-2.1 d;significant differences between both groups (P 0.05);control patients (P 0.05). Conclusion: in the clinical treatment of patients with upper gastrointestinal bleeding, it can achieve an ideal hemostasis effect in a relatively short time, and has a higher safety value. It is suggested to be widely used in clinical practice.展开更多
Objective: to explore the effect of programmed nursing in endoscopic mucosal dissection. Methods: from January 2020 to December 2020, 64 patients were randomly selected from patients undergoing endoscopic mucosal diss...Objective: to explore the effect of programmed nursing in endoscopic mucosal dissection. Methods: from January 2020 to December 2020, 64 patients were randomly selected from patients undergoing endoscopic mucosal dissection in our hospital as the case of this study. 64 patients were randomly divided into two groups: the control group and the observation group, with 32 cases in each group. In this study, the selected patients were given differentiated nursing, in which the control group was given conventional nursing measures and the observation group was given programmed nursing measures. When the patient is cured and discharged from hospital, the time of operation, the success rate of operation and the incidence of complications are investigated. Results: the solitary spherical lesion in the lung could be detected by CT and X-ray, but the detection rate by CT was 97%, which was significantly higher than that by X-ray. The data between the two groups had a large difference (P < 0.05). Conclusion: compared with routine nursing care, programmed nursing care for patients during the perioperative period of digestive endoscopic mucosal dissection can effectively shorten the operation time of patients and improve the success rate of surgery.展开更多
AIM:Capsule endoscopy has demonstrated its clinical utility in the evaluation of small bowel pathology in several Western studies.In this prospective study,we aimed to determine the clinical utility,safety and tolerab...AIM:Capsule endoscopy has demonstrated its clinical utility in the evaluation of small bowel pathology in several Western studies.In this prospective study,we aimed to determine the clinical utility,safety and tolerability of capsule endoscopy in the evaluation of suspected small bowel disease in an urban Southeast Asian population. METHODS:We used the given (M2A) capsule endoscopy system in 16 consecutive patients with suspected small bowel pathology.In 9 patients the indication was obscure gastrointestinal bleeding,while in 6 patients it was to determine the extent of small bowel involvement in Crohn's disease.One patient underwent capsule endoscopy for evaluation of chronic abdominal pain.Patient's tolerability to the procedure was evaluated by standardized questionnaires and all patients were reviewed at one week to ensure that the capsule had been excreted without any adverse events. RESULTS:Abnormal findings were present in 8 patients (50%).The cause of obscure gastrointestinal bleeding was determined in 5 out of 9 patients.Findings included 2 cases of angiodysplasia,2 cases of jejunal ulcers and 1 case of both angiodysplasia and jejunal ulcer.One patient had small bowel erosions and loci of erythema of doubtful significance. Ileal lesions were diagnosed in 2 out of 6 patients with Crohn's disease.Capsule endoscopy was well tolerated by all patients.One patient with Crohn's disease had a complication of capsule retention due to terminal ileum stricture.The capsule eventually passed out spontaneously after i month. CONCLUSION:Our study,which represented the first Asian series,further confirms the diagnostic utility,safety and tolerability of wireless capsule endoscopy.展开更多
AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Conscious sedation (CS) and non-pharmacological interventions have been proposed to reduce anxiety and allow better execut...AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Conscious sedation (CS) and non-pharmacological interventions have been proposed to reduce anxiety and allow better execution of EGD. The aim of this study was to assess whether CS, supplementary information with a videotape, or presence of a relative during the examination could improve the tolerance to EGD. METHODS: Two hundred and twenty-six outpatients (pts), scheduled for a first-time non-emergency EGD were randomly assigned to 4 groups: Co-group (62 pts): throat anaesthesia only; Mi-group (52 pts): CS with i.v. midazolam; Re-group (58 pts): presence of a relative throughout the procedure; Vi-group (54 pts): additional information with a videotape. Anxiety was measured using the “Spielberger State and Trait Anxiety Scales” The patients assessed the overall discomfort during the procedure on an 100-mm visual analogue scale, and their tolerance to EGD answering a questionnaire. The endoscopist evaluated the technical difficulty of the examination and the tolerance of the patients on an 100-mm visual analogue scale and answering a questionnaire. RESULTS: Pre-endoscopy anxiety levels were higher in the Mi-group than in the other groups (P<0.001). On the basis of the patients' evaluation, EGD was well tolerated by 80.7% of patients in Mi-group, 43.5% in Co-group, 58.6% in Regroup, and 50% in Vi-group (P<0.01). The discomfort caused by EGD, evaluated by either the endoscopist or the patients, was lower in Mi-group than in the other groups. The discomfort was correlated with “age” (P<0.001) and “groups of patients” (P<0.05) in the patients' evaluation, and with “gender” (females tolerated better than males, P<0.001) and “groups of patients” (P<0.05) in the endoscopist's evaluation. CONCLUSION: Conscious sedation can improve the tolerance to EGD. Male gender and young age are predictive factors of bad tolerance to the procedure.展开更多
文摘Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderly GP patients admitted between June 2021 and December 2022 were selected.Patients were randomly divided into two groups:the painless group(50 cases)underwent high-frequency electrosurgical knife surgery guided by PDE,while the conventional group(50 cases)underwent the same surgery guided by traditional digestive endoscopy(DE).The total treatment efficacy,perioperative indicators,gastrointestinal hormone levels,oxidative stress(OS)markers,and complication rates were compared between the two groups.Results:The total treatment efficacy in the painless group was higher than that in the conventional group,and perioperative indicators were superior in the painless group(P<0.05).One week after treatment,the gastrointestinal hormone levels and OS-related markers in the painless group were better than those in the conventional group(P<0.05).The complication rate in the painless group was lower than in the conventional group(P<0.05).Conclusion:High-frequency electrosurgical knife surgery guided by PDE improves the effectiveness of polyp removal in elderly GP patients and accelerates postoperative recovery.It also protects gastrointestinal function,reduces postoperative OS,and ensures higher surgical safety.
文摘AIM:To assess the adoption of Carbon dioxide(CO2)insufflation by endoscopists from various European countries,and its determinants.METHODS:A survey was distributed to 580 endoscopists attending a live course on digestive endoscopy.RESULTS:The response rate was 24.5%.Fewer than half the respondents(66/142,46.5%)were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy,and 4.2%of respondents were actually using CO2 as the insufflation agent.Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice(84%and 49%of answers,respectively;two answers were permitted for this item).CONCLUSION:Based on this survey,adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional.A majority of endoscopists were not aware of this possibility,while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.
文摘BACKGROUND As lifestyles continue to change worldwide,the incidence of digestive tract carcinoma has gradually increased.Digestive endoscopy is an important tool that can assist in the diagnosis,treatment,and surgical intervention for this disease.However,the examination process is affected by many factors,and patient cooperation is often poor,which can increase the risk of complications.AIM To explore the effects of integrated management and cognitive intervention on cooperation and complications in patients undergoing endoscopy for early gastrointestinal neoplasms.METHODS A total of 354 patients with early stage gastrointestinal cancer who underwent digestive endoscopy procedures between January and December 2023 at our hospital were divided into observation and control groups(177 patients in each group)in a randomized controlled blind trial.The control group received routine interventions,while the observation group received comprehensive integrated management combined with cognitive interventions.We compared the changes in adverse mood,discomfort,examination time,cooperation with the examination,and complications before and after the intervention between the two groups.RESULTS The self-rated anxiety and depression scale scores were lower in the observation group than in the control group(P<0.05).The visual analog scale scores for discomfort during intubation and examination were also lower in the observation group than in the control group(P<0.05).Furthermore,the examination time was shorter in the observation group than in the control group(P<0.05),and the degree of cooperation(94.35%)was higher in the observation group than in the control group(84.75%;P<0.05).Lastly,the incidence rates of gastrointestinal adverse reactions(10.17%vs 20.34%),choking agitation(14.69%vs 24.86%),abdominal pain(8.47%vs 18.08%),and muscle tension(5.08%vs 14.12%)were all lower in the observation group than in the control group(P<0.05).CONCLUSION Integrated management and cognitive intervention in early gastrointestinal neoplasm endoscopy alleviate mood,reduce discomfort,shorten examinations,improve cooperation,and reduce complications.
文摘<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It represents one of the most common pathological entities in</span> gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP).<b> Materials and Method: </b>This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy <span>unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) re</span>ports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. <b>Results: </b>The reports of 593 patients were analyzed. The mean age was 45 years </span></span></span><span><span><span style="font-family:;" "="">old </span></span></span><span><span><span style="font-family:;" "="">(range 8 - 88 years</span></span></span><span><span><span style="font-family:;" "=""> old</span></span></span><span><span><span style="font-family:;" "="">) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of <span>cases. The endoscopic appearance was normal in 229 patients (39%). The</span> endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). <i>H</i>. <i>pylori</i> was present in 404 patients (68%).<b> Conclusion: </b>Gastritis is </span></span></span><span><span><span style="font-family:;" "="">usually</span></span></span><span><span><span style="font-family:;" "=""> found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.</span></span></span>
文摘<strong>Background:</strong><span><span><span style="font-family:;" "=""> Endoscopy remains the most performant medical exam exploring the upper digestive tract;but depending on patients, its tolerance is variable.<b> Objective: </b>This study aimed at describing the experience and evaluating the tolerance, acceptability and injuries observed during upper gastrointestinal endoscopy. <b>Methods:</b> This is a prospective and descriptive study carried out from April to July 2017 in the digestive endoscopy unit of the Kara teaching hospital</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(Togo). The gastroscopy was performed by the same operator (Hepatogastroenteroloogist). The premedication was done with direct intravenous injection of 10 mg of Metoclopramide hydrochloride and viscous Lidocaine oral gel. Previously, essential information about the examination course was given to patients after obtaining their verbal consent. Patients’ impressions of the experience, tolerance and acceptability were collected on a survey sheet, before and after the examination.<b> Results:</b> One hundred and eleven patients were included, 62 women and 49 men. The average age was 45.9 years (15</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">88 years), and the sex ratio</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(F/M) was 1.2. Most of the patients (89.2%) were experiencing the gastroscopy for the first time, and the main reason was epigastralgia in 55%. The examination duration was good at 88.3% and tolerance was good at 72.1%. Tingling, irritation, pain or sore throat feelings were noted in 13.5%. Patients agreeing to make an ulterior UDE if necessary were up to 92.8%. Observed injuries were dominated by antral erythematous gastropathy (28.8%).</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Conclusion:</span></b></span></span><span><span><span style="font-family:;" "=""> UDE is well tolerated among our patients and its acceptability is high. Injuries are dominated by inflammatory pathologies of the stomach in our population.</span></span></span>
文摘<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of <i>H. pylori</i> infection. <b>Material and Methods:</b> This is a retrospective, descriptive and analytical study, ranging from the 16<sup>th</sup> of December 2014 to the 16<sup>th</sup> of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. <b>Results:</b> fifty-five percent of these patients were women.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">66% of the patients were under 50</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">years of age. Their major symptom was epigastric pain</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(89.2%),</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">the most observed endoscopic lesion was erythematous gastritis</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(82%) therefore we have noticed 21</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span><span><span><span style="font-family:;" "="">5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, <i>NSAID</i> and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). <i>Helicobacter pylori</i> gastritis was the most frequent (61.30%) and</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><i><span style="font-family:;" "="">Helicobacter pylori</span></i></span></span><span><span><span style="font-family:;" "=""> were present in 63% of gastric biopsies. <b>Conclusion: </b>Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.</span></span></span>
文摘Objective: this study mainly studies the treatment of patients with intestinal polyps, and conducts the treatment process under the control of gastrointestinal endoscopy, in order to improve the treatment effect of these patients, shorten the treatment time and recovery time of the patients, and improve the life of the patients. quality. Methods: This study selected 72 patients with intestinal polyps who came to our hospital from November 2020 to January 2022. All patients received intestinal polyp treatment as part of gastrointestinal endoscopy. In order to observe the research results, the selected patients were compared and examined in order to better observe the research results. During the examination of all selected patients, the nursing effect and the occurrence of adverse events should be carefully recorded and compared. At the same time, before nursing the selected patients, professional medical staff will evaluate the overall condition of the patients to ensure that the patients can cooperate in the process of this study, and then they can be included in the study. Patients should also take the initiative to inform patients of the research content and purpose, and the research results can be published only with the consent of patients. Results: two different nursing methods had different effects on selected patients, but relatively high-quality nursing methods were preferred by patients, which minimized adverse reactions during the patient's recovery. There were differences in the results across all patients, which better support the data from this study.
文摘Objective To explore the application of digestive endoscopy in the treatment of upper gastrointestinal bleeding. Methods Fifty patients in our hospital from July 2017 to July 2022 were randomly divided into two groups, 25 patients in each group. The curative effects of the two groups were compared by conventional drug therapy and digestive endoscopy therapy. Results Compared with the control group, the observation group had higher curative effect and lower other indexes (P0.05). Conclusion: the common disease in digestive department is upper gastrointestinal bleeding, the main cause of which is peptic ulcer. The main inducing factors of this disease are Hp infection and the use of non-steroidal anti-inflammatory drugs. The correct treatment depends on reliable evaluation, solid professional skills of clinicians and appropriate intervention. With the clinical application of endoscopic hemostasis, antacids and eradication of Hp, the effective rate of treatment of this disease has been greatly increased, but despite this, the morbidity and mortality of this disease have only increased. At present, clinical practice shows that endoscopic treatment has become the main treatment for gastrointestinal bleeding caused by non-varicose veins. If the volume of body fluid is normal, the hemodynamic stability is stable, and gastroscopy treatment is performed within 24 hours, and the diagnosis evidence can be made clear so that patients can be treated clearly. Before endoscopic examination, proton pump inhibitor was given to reduce the bleeding rate and the need for endoscopic therapy, but it had low influence on rebleeding rate, mortality and surgical operation, and reduced rebleeding rate. For high-risk patients, endoscopic treatment can prevent postoperative rebleeding, and can also reduce the need for later intervention, mortality and other indicators.
文摘Objective: to explore the effect of risk management in digestive endoscopy room. Methods: 100 patients who were diagnosed and treated in digestive endoscopy room from November 2019 to November 2020 were studied. Computer numerical table method is divided into control group (routine basic nursing) 50 cases and management group (risk management nursing) 50 cases. Record the nursing quality and satisfaction of the control group and the management group, and the proportion of adverse events in each group. Results: the nursing satisfaction of the patients in the management group was higher than that of the control group, and the incidence of adverse events in the management group was lower than that of the control group. The difference was statistically significant (P < 0.05). Conclusion: the application of risk management in digestive endoscopy room has obvious effect, reducing the occurrence of adverse events in the process of diagnosis and treatment of patients, and improving the satisfaction and compliance of nursing care. It can be used for the treatment of diseases and is suitable for clinical application.
文摘Objective: in the process of diagnosis and treatment of digestive endoscopy, different nursing schemes are adopted to summarize and explore the implementation effect of comfort nursing scheme and the improvement of patient comfort and negative reaction. Methods: from January 20 to January 21, 92 cases were included in our hospital for digestive endoscopy diagnosis and treatment. They were divided into two groups according to the nursing mode. The number of cases included was 46. According to the nursing means, it is named as routine nursing group and comfort nursing group. In the nursing process, the nursing scheme adopted by the routine nursing group for patients is traditional routine nursing, and the nursing scheme adopted by the comfort nursing group for patients is comfort nursing intervention. Summarize and explore the effect of nursing implementation. Results: (1) after comparison, the score of comfort nursing in the routine group was lower and that in the comfort nursing group was higher. There was significant difference between the two groups (P < 0.05). (2) By comparison, the incidence of adverse reactions was higher in the routine nursing group and lower in the comfortable nursing group (P < 0.05). (3) By comparison, the recovery time of gastrointestinal function was longer in the routine nursing group and shorter in the comfort nursing group (P < 0.05). Conclusion: in the process of gastrointestinal endoscopy diagnosis and treatment, combined with comfort nursing intervention can improve the quality of nursing. This scheme is worthy of clinical application and popularization.
文摘Digestive endoscopy is a special optical instrument for medical diagnosis, which is mainly used to probe the endoscope into the digestive tract of patients to observe whether there are abnormalities or pathological changes. Because of its own rapidity and intuition, digestive endoscopy has been unanimously approved by medical staff and patients, and has also been more widely used in clinical medicine. With the change of lifestyle, more and more people suffer from diseases in the digestive tract. In order to achieve effective treatment and provide a more scientific basis for the operation, medical personnel must have an understanding of the actual disease situation of patients and accurately grasp the pathological changes of patients. This is also the main advantage of digestive endoscopy. In order to provide more safety guarantee for patients, the personnel using the digestive endoscope must have an understanding of the use method and basic structure of the digestive endoscope, be able to accurately judge the problems occurring in the use process of the digestive endoscope, carefully maintain and reduce the occurrence of faults, enable the equipment to have a longer use time, reduce the equipment maintenance consumption and maintain the normal operation of the hospital.
文摘Objective: to explore the effect of seamless nursing quality management in the diagnosis and treatment of patients with digestive endoscopy. Methods: from February 2020 to February 2021, 114 patients with digestive endoscopy received by our hospital were randomly selected for the RCT study, and randomly divided into project group and preset group (general nursing), and the nursing effects of the two groups were compared. Results: compared with the preset group, the incidence of complications in the project group was lower, and the nursing compliance and nursing satisfaction were higher, with statistical significance between the two groups (P < 0.05). Conclusion: the application of seamless nursing quality management in patients with digestive endoscopy can reduce the risk of complications, improve nursing compliance and nursing satisfaction, and is suitable for clinical promotion.
文摘Objective: to explore the effect of psychological intervention combined with detailed nursing on stress response and examination cooperation degree of patients undergoing digestive endoscopy. Methods: 206 patients undergoing digestive endoscopy in our hospital from March 2021 to December 2021 were selected as the research objects, and divided into control group and observation group according to the principle of comparability of basic characteristics between groups, with 103 cases in each group. The control group received routine nursing while the observation group received psychological intervention combined with detailed nursing. The stress response, psychological state and cooperation degree of the two groups were compared. Results: after psychological intervention combined with detailed nursing intervention, the heart rate, systolic blood pressure and diastolic blood pressure of patients in the observation group were significantly lower than those in the control group 5 minutes before endoscopic examination (P < 0.05). The heart rate and systolic blood pressure of the observation group were significantly lower than those of the control group 5 minutes after the examination (P<0.05). Before psychological intervention combined with detailed nursing, there was no significant difference in SAS and SDS scores between the two groups (P > 0.05). 6 hours after the intervention, the SAS and SDS scores of the observation group were significantly lower than those of the control group (P<0.05). The overall coordination degree of the observation group was significantly higher than that of the control group (P<0.05). Conclusion psychological intervention combined with detailed nursing can significantly reduce patients' stress reaction, improve patients' cooperation degree, and relieve patients' anxiety and depression.
基金This research was supported by the Science and Technology Commission of Shanghai Municipality(No.21Y31900100)the National Natural Science Foundation of China(No.82270679).
文摘Background:China has made significant progress in medical accessibility and quality over the past decades,and quality improvements in gastroenterology and digestive endoscopy have been consistent.The study aimed to describe the status quo of gastroenterology and digestive endoscopy in the Chinese mainland based on the data from the National Clinical Improvement System(NCIS)and the Hospital Quality Monitoring System(HQMS).Methods:Data were extracted from the NCIS and the HQMS.Data analysis included general information from the Department of Gastroenterology and Endoscopy centers,management of inpatients and outpatients,and annual volume and quality indicators of digestive endoscopy.Acute pancreatitis,gastrointestinal bleeding,inflammatory bowel disease,and cirrhosis were identified as priority diseases and were subjected to detailed analysis.Results:Data from 4620 and 7074 hospitals were extracted from the NCIS and HQMS,respectively.In 2023,9.6 gastroenterologists,6.7 endoscopists,and 37.3 gastroenterology beds per hospital nationwide were observed,achieving 19,252.4 outpatient visits,1615.2 hospitalizations(97.0 for acute pancreatitis,146.1 for gastrointestinal bleeding,40.2 for inflammatory bowel disease,and 111.4 for cirrhosis),and 9432.7 digestive endoscopic procedures per hospital.Overall,the quality of practice improved significantly.The proportion of early cancer among gastrointestinal cancers increased from 11.1%in 2015 to 23.4%in 2023,and the adenoma detection rate during colonoscopy increased from 19.3%in 2019 to 26.9%in 2023.Regarding priority diseases,hospitalizations increased,and 31-day unplanned readmission rates decreased between 2019 and 2023.The median hospitalization costs and median proportion of medication costs decreased for acute pancreatitis,gastrointestinal bleeding,and cirrhosis.However,it increased for inflammatory bowel disease.Conclusion:This report evaluates the status quo and development of gastroenterology and digestive endoscopy in the Chinese mainland,providing guidance for future quality improvements.
文摘BACKGROUND Propofol is commonly used for sedation during endoscopic procedures.Data suggests its superiority to traditional sedatives used in endoscopy including benzodiazepines and opioids with more rapid onset of action and improved postprocedure recovery times for patients.However,Propofol requires administration by trained healthcare providers,has a narrow therapeutic index,lacks an antidote and increases risks of cardio-pulmonary complications.AIM To compare,through a systematic review of the literature and meta-analysis,sedation with propofol to traditional sedatives with or without propofol during endoscopic procedures.METHODS A literature search was performed using MEDLINE,Scopus,EMBASE,the Cochrane Library,Scopus,LILACS,BVS,Cochrane Central Register of Controlled Trials,and The Cumulative Index to Nursing and Allied Health Literature databases.The last search in the literature was performed on March,2019 with no restriction regarding the idiom or the year of publication.Only randomized clinical trials with full texts published were included.We divided sedation therapies to the following groups:(1)Propofol versus benzodiazepines and/or opiate sedatives;(2)Propofol versus Propofol with benzodiazepine and/or opioids;and(3)Propofol with adjunctive benzodiazepine and opioid versus benzodiazepine and opioid.The following outcomes were addressed:Adverse events,patient satisfaction with type of sedation,endoscopists satisfaction with sedation administered,dose of propofol administered and time to recovery post procedure.Meta-analysis was performed using RevMan5 software version 5.39.RESULTS A total of 23 clinical trials were included(n=3854)from the initial search of 6410 articles.For Group I(Propofol vs benzodiazepine and/or opioids):The incidence of bradycardia was not statistically different between both sedation arms(RD:-0.01,95%CI:-0.03–+0.01,I2:22%).In 10 studies,the incidence of hypotension was not statistically difference between sedation arms(RD:0.01,95%CI:-0.02–+0.04,I2:0%).Oxygen desaturation was higher in the propofol group but not statistically different between groups(RD:-0.03,95%CI:-0.06–+0.00,I2:25%).Patients were more satisfied with their sedation in the benzodiazepine+opioid group compared to those with monotherapy propofol sedation(MD:+0.89,95%CI:+0.62–+1.17,I2:39%).The recovery time after the procedure showed high heterogeneity even after outlier withdrawal,there was no statistical difference between both arms(MD:-15.15,95%CI:-31.85–+1.56,I2:99%).For Group II(Propofol vs propofol with benzodiazepine and/or opioids):Bradycardia had a tendency to occur in the Propofol group with benzodiazepine and/or opioidassociated(RD:-0.08,95%CI:-0.13–-0.02,I2:59%).There was no statistical difference in the incidence of bradycardia(RD:-0.00,95%CI:-0.08–+0.08,I2:85%),desaturation(RD:-0.00,95%CI:-0.03–+0.02,I2:44%)or recovery time(MD:-2.04,95%CI:-6.96–+2.88,I2:97%)between sedation arms.The total dose of propofol was higher in the propofol group with benzodiazepine and/or opiates but with high heterogeneity.(MD:70.36,95%CI:+53.11–+87.60,I2:61%).For Group III(Propofol with benzodiazepine and opioid vs benzodiazepine and opioid):Bradycardia and hypotension was not statistically significant between groups(RD:-0.00,95%CI:-0.002–+0.02,I2:3%;RD:0.04,95%CI:-0.05–+0.13,I2:77%).Desaturation was evaluated in two articles and was higher in the propofol+benzodiazepine+opioid group,but with high heterogeneity(RD:0.15,95%CI:0.08–+0.22,I2:95%).CONCLUSION This meta-analysis suggests that the use of propofol alone or in combination with traditional adjunctive sedatives is safe and does not result in an increase in negative outcomes in patients undergoing endoscopic procedures.
文摘Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.
文摘Objective: to explore the clinical effect of upper digestive system hemorrhage under gastrointestinal endoscopy. Methods: the 100 patients with massive upper digestive system bleeding hospitalized from February 2018 to September 2020 were divided into two groups according to the treatment plan, 50 patients underwent gastroscopy, 50 patients received traditional hemostasis, and the results were compared with the time of hemostasis treatment. Results: comparing the efficacy of the two methods, the hemostasis visualization efficiency of 50 patients was 96% compared to 78%;the bleeding duration (0.87 + 0.35) d, admission days (3.4) d;1.89 + 1.12 d in treatment group, 5.8-2.1 d;significant differences between both groups (P 0.05);control patients (P 0.05). Conclusion: in the clinical treatment of patients with upper gastrointestinal bleeding, it can achieve an ideal hemostasis effect in a relatively short time, and has a higher safety value. It is suggested to be widely used in clinical practice.
文摘Objective: to explore the effect of programmed nursing in endoscopic mucosal dissection. Methods: from January 2020 to December 2020, 64 patients were randomly selected from patients undergoing endoscopic mucosal dissection in our hospital as the case of this study. 64 patients were randomly divided into two groups: the control group and the observation group, with 32 cases in each group. In this study, the selected patients were given differentiated nursing, in which the control group was given conventional nursing measures and the observation group was given programmed nursing measures. When the patient is cured and discharged from hospital, the time of operation, the success rate of operation and the incidence of complications are investigated. Results: the solitary spherical lesion in the lung could be detected by CT and X-ray, but the detection rate by CT was 97%, which was significantly higher than that by X-ray. The data between the two groups had a large difference (P < 0.05). Conclusion: compared with routine nursing care, programmed nursing care for patients during the perioperative period of digestive endoscopic mucosal dissection can effectively shorten the operation time of patients and improve the success rate of surgery.
文摘AIM:Capsule endoscopy has demonstrated its clinical utility in the evaluation of small bowel pathology in several Western studies.In this prospective study,we aimed to determine the clinical utility,safety and tolerability of capsule endoscopy in the evaluation of suspected small bowel disease in an urban Southeast Asian population. METHODS:We used the given (M2A) capsule endoscopy system in 16 consecutive patients with suspected small bowel pathology.In 9 patients the indication was obscure gastrointestinal bleeding,while in 6 patients it was to determine the extent of small bowel involvement in Crohn's disease.One patient underwent capsule endoscopy for evaluation of chronic abdominal pain.Patient's tolerability to the procedure was evaluated by standardized questionnaires and all patients were reviewed at one week to ensure that the capsule had been excreted without any adverse events. RESULTS:Abnormal findings were present in 8 patients (50%).The cause of obscure gastrointestinal bleeding was determined in 5 out of 9 patients.Findings included 2 cases of angiodysplasia,2 cases of jejunal ulcers and 1 case of both angiodysplasia and jejunal ulcer.One patient had small bowel erosions and loci of erythema of doubtful significance. Ileal lesions were diagnosed in 2 out of 6 patients with Crohn's disease.Capsule endoscopy was well tolerated by all patients.One patient with Crohn's disease had a complication of capsule retention due to terminal ileum stricture.The capsule eventually passed out spontaneously after i month. CONCLUSION:Our study,which represented the first Asian series,further confirms the diagnostic utility,safety and tolerability of wireless capsule endoscopy.
文摘AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Conscious sedation (CS) and non-pharmacological interventions have been proposed to reduce anxiety and allow better execution of EGD. The aim of this study was to assess whether CS, supplementary information with a videotape, or presence of a relative during the examination could improve the tolerance to EGD. METHODS: Two hundred and twenty-six outpatients (pts), scheduled for a first-time non-emergency EGD were randomly assigned to 4 groups: Co-group (62 pts): throat anaesthesia only; Mi-group (52 pts): CS with i.v. midazolam; Re-group (58 pts): presence of a relative throughout the procedure; Vi-group (54 pts): additional information with a videotape. Anxiety was measured using the “Spielberger State and Trait Anxiety Scales” The patients assessed the overall discomfort during the procedure on an 100-mm visual analogue scale, and their tolerance to EGD answering a questionnaire. The endoscopist evaluated the technical difficulty of the examination and the tolerance of the patients on an 100-mm visual analogue scale and answering a questionnaire. RESULTS: Pre-endoscopy anxiety levels were higher in the Mi-group than in the other groups (P<0.001). On the basis of the patients' evaluation, EGD was well tolerated by 80.7% of patients in Mi-group, 43.5% in Co-group, 58.6% in Regroup, and 50% in Vi-group (P<0.01). The discomfort caused by EGD, evaluated by either the endoscopist or the patients, was lower in Mi-group than in the other groups. The discomfort was correlated with “age” (P<0.001) and “groups of patients” (P<0.05) in the patients' evaluation, and with “gender” (females tolerated better than males, P<0.001) and “groups of patients” (P<0.05) in the endoscopist's evaluation. CONCLUSION: Conscious sedation can improve the tolerance to EGD. Male gender and young age are predictive factors of bad tolerance to the procedure.
