目的:描述内镜黏膜下剥离术(ESD)后使用自控式水囊的体验,旨在为该人群护理提供参考依据。方法:采用田野式访谈,按照目的抽样法,于2024.01~2024.06选取在上海市东方医院内镜中心内镜黏膜下剥离术后复诊治疗50例患者进行访谈,并以内容分...目的:描述内镜黏膜下剥离术(ESD)后使用自控式水囊的体验,旨在为该人群护理提供参考依据。方法:采用田野式访谈,按照目的抽样法,于2024.01~2024.06选取在上海市东方医院内镜中心内镜黏膜下剥离术后复诊治疗50例患者进行访谈,并以内容分析法归纳和提炼主题。结果:提炼出5个主题及11个亚主题;生理不适感(身体层面不适感、迫切渴望拔除气囊)、心理不适感(病耻感、焦虑)、生活质量下降(生活习惯改变、睡眠质量降低)、期待社会支持(期待理解和尊重、依赖家庭支持、渴望社会支持)、疾病自我管理能力不足(预后的认知较差、水囊使用依从性)。结论:内镜黏膜下剥离术后使用自控式水囊的患者除了对疾病焦虑外,对于水囊的使用、使用注意事项以及过程中的各种支持仍有较高的需求。未来应制定多方位干预措施,促进其更好地疾病康复、尽快恢复正常生活。Objective: To describe the experience of using a self controlled water balloon after endoscopic submucosal dissection (ESD), with the aim of providing a reference for nursing care for this population. Method: Field interviews were conducted using purposive sampling. From January 2024 to June 2024, 50 patients who underwent follow-up treatment after endoscopic submucosal dissection at the Endoscopy Center of Dongfang Hospital in Shanghai were selected for interviews. Content analysis was used to summarize and extract themes. As a result, 5 themes and 11 sub-themes were extracted: Physiological discomfort (physical discomfort, an urgent desire to remove the balloon), psychological discomfort (sense of shame, anxiety), decreased quality of life (changes in daily habits, reduced sleep quality), expectation of social support (desire for understanding and respect, reliance on family support, longing for societal support), and inadequate disease self-management (poor prognosis awareness, compliance with balloon usage). Conclusion: Patients who use self controlled water balloon after endoscopic submucosal dissection still have a high demand for the use of water sacs, precautions, and various supports during the process, in addition to disease anxiety. In the future, multi-faceted intervention measures should be developed to promote better disease recovery and prompt resumption of normal life.展开更多
目的:探讨水下内镜下黏膜切除术(UEMR)治疗十二指肠平坦型病变的效果。方法:回顾性分析青岛大学附属医院消化内科收治的1例十二指肠降部平坦型息肉病例的临床、内镜特点及其内镜治疗结果。结果:60岁女性因常规查体行胃镜检查,白光内镜...目的:探讨水下内镜下黏膜切除术(UEMR)治疗十二指肠平坦型病变的效果。方法:回顾性分析青岛大学附属医院消化内科收治的1例十二指肠降部平坦型息肉病例的临床、内镜特点及其内镜治疗结果。结果:60岁女性因常规查体行胃镜检查,白光内镜十二指肠降部见约10 × 8 mm低平隆起,NBI结合放大胃镜显示病变边界清晰,微血管及微结构欠规则。行UEMR完整切除病变,术后病理为管状腺瘤,无并发症发生。结论:UEMR操作简单,完整切除率高,术后并发症少,复发率低,可作为内镜下切除十二指肠平坦型病变简单、安全、有效的方法进行临床推广。Objective: To evaluate the therapeutic efficacy of underwater endoscopic mucosal resection (UEMR) in the management of duodenal flat lesions. Methods: We present a case study involving a patient with a flat polyp in the descending duodenum who was admitted to the Gastroenterology Department of the Affiliated Hospital of Qingdao University. A retrospective analysis was conducted to examine the patient’s clinical presentation, endoscopic characteristics, and outcomes following endoscopic treatment. Results: A 60-year-old woman underwent gastroscopy due to routine checkup, and about 10 × 8 mm low flat bulge was seen in the descending part of duodenum under white light endoscopy, and NBI combined with magnified gastroscopy showed that the lesion had clear boundaries, and microvessels and microstructures were under-regularized. UEMR was performed for complete resection of the lesion, and the postoperative pathology was tubular adenoma without complications. Conclusion: UEMR is simple to operate, with a high rate of complete resection, few postoperative complications, and a low recurrence rate, and can be clinically promoted as a simple, safe, and effective method for endoscopic resection of duodenal flat lesions.展开更多
文摘目的:描述内镜黏膜下剥离术(ESD)后使用自控式水囊的体验,旨在为该人群护理提供参考依据。方法:采用田野式访谈,按照目的抽样法,于2024.01~2024.06选取在上海市东方医院内镜中心内镜黏膜下剥离术后复诊治疗50例患者进行访谈,并以内容分析法归纳和提炼主题。结果:提炼出5个主题及11个亚主题;生理不适感(身体层面不适感、迫切渴望拔除气囊)、心理不适感(病耻感、焦虑)、生活质量下降(生活习惯改变、睡眠质量降低)、期待社会支持(期待理解和尊重、依赖家庭支持、渴望社会支持)、疾病自我管理能力不足(预后的认知较差、水囊使用依从性)。结论:内镜黏膜下剥离术后使用自控式水囊的患者除了对疾病焦虑外,对于水囊的使用、使用注意事项以及过程中的各种支持仍有较高的需求。未来应制定多方位干预措施,促进其更好地疾病康复、尽快恢复正常生活。Objective: To describe the experience of using a self controlled water balloon after endoscopic submucosal dissection (ESD), with the aim of providing a reference for nursing care for this population. Method: Field interviews were conducted using purposive sampling. From January 2024 to June 2024, 50 patients who underwent follow-up treatment after endoscopic submucosal dissection at the Endoscopy Center of Dongfang Hospital in Shanghai were selected for interviews. Content analysis was used to summarize and extract themes. As a result, 5 themes and 11 sub-themes were extracted: Physiological discomfort (physical discomfort, an urgent desire to remove the balloon), psychological discomfort (sense of shame, anxiety), decreased quality of life (changes in daily habits, reduced sleep quality), expectation of social support (desire for understanding and respect, reliance on family support, longing for societal support), and inadequate disease self-management (poor prognosis awareness, compliance with balloon usage). Conclusion: Patients who use self controlled water balloon after endoscopic submucosal dissection still have a high demand for the use of water sacs, precautions, and various supports during the process, in addition to disease anxiety. In the future, multi-faceted intervention measures should be developed to promote better disease recovery and prompt resumption of normal life.
文摘目的:探讨水下内镜下黏膜切除术(UEMR)治疗十二指肠平坦型病变的效果。方法:回顾性分析青岛大学附属医院消化内科收治的1例十二指肠降部平坦型息肉病例的临床、内镜特点及其内镜治疗结果。结果:60岁女性因常规查体行胃镜检查,白光内镜十二指肠降部见约10 × 8 mm低平隆起,NBI结合放大胃镜显示病变边界清晰,微血管及微结构欠规则。行UEMR完整切除病变,术后病理为管状腺瘤,无并发症发生。结论:UEMR操作简单,完整切除率高,术后并发症少,复发率低,可作为内镜下切除十二指肠平坦型病变简单、安全、有效的方法进行临床推广。Objective: To evaluate the therapeutic efficacy of underwater endoscopic mucosal resection (UEMR) in the management of duodenal flat lesions. Methods: We present a case study involving a patient with a flat polyp in the descending duodenum who was admitted to the Gastroenterology Department of the Affiliated Hospital of Qingdao University. A retrospective analysis was conducted to examine the patient’s clinical presentation, endoscopic characteristics, and outcomes following endoscopic treatment. Results: A 60-year-old woman underwent gastroscopy due to routine checkup, and about 10 × 8 mm low flat bulge was seen in the descending part of duodenum under white light endoscopy, and NBI combined with magnified gastroscopy showed that the lesion had clear boundaries, and microvessels and microstructures were under-regularized. UEMR was performed for complete resection of the lesion, and the postoperative pathology was tubular adenoma without complications. Conclusion: UEMR is simple to operate, with a high rate of complete resection, few postoperative complications, and a low recurrence rate, and can be clinically promoted as a simple, safe, and effective method for endoscopic resection of duodenal flat lesions.
