新型冠状病毒肺炎疫情期间河北省27家三级甲等医院消化内镜开展情况的调查报告

目的探讨新型冠状病毒肺炎疫情对河北省消化内镜诊疗工作的影响。方法采用调查问卷表方式,对河北省27家三级甲等医院进行调查,比较新型冠状病毒肺炎疫情期间(2020年1月1日—4月10日)与2019年同期河北省消化内镜诊疗工作开展情况及变化。结果 2020年新型冠状病毒肺炎疫情期间,消化内镜检查总量同比减少46. 0%,内镜治疗量同比减少40. 9%,以2月降低最为明显。急诊胃镜诊疗总量下降,但急诊胃镜在所有内镜检查中的占比较2019年同期显著增高(2. 0%vs. 1. 8%,P 0. 05)。新型冠状病毒肺炎疫情期间,经内镜逆行胰胆管造影术(ERCP)在内镜治疗中占比较2019年同期显著增高(14. 8%vs. 11. 4%,P 0. 05)。结论在新型冠状病毒肺炎疫情期间,河北省消化内镜检查量及治疗量均较2019年同期显著下降,但急诊胃镜和ERCP比率同比增长,最大限度地保障了危急重症消化道疾病患者的诊治。本研究为今后国家医疗系统应急管理提供决策参考。     

新型冠状病毒肺炎疫情下基层医院行急诊消化内镜诊疗患者的管理策略探讨

目的 研究新型冠状病毒肺炎(以下简称"新冠肺炎")疫情下基层医院急诊消化内镜患者就诊流程,探讨基层医院急诊消化内镜患者管理策略.方法 回顾性研究漳州市龙海区第一医院2020年2月至4月本院对急诊消化内镜患者进行预检分诊及分类管理的就诊流程,并分析期间患者及医务人员新型冠状病毒感染率、患者病情好转率.结果 2020年2月...     

儿童和青少年4803例消化内镜诊治结果分析

随着消化内镜诊治技术的飞速发展,胃镜、结肠镜、ERCP（endoscopic retrograde cholangiopancreatography）等在儿童和青少年消化道疾病的诊治中得到广泛的应用。但是从单中心综合分析儿童和青少年消化道疾病内镜诊治结果的文献报道较少,为了进一步探讨儿童和青少年消化道疾病的特点,消化内镜的临床应用价值及分析相关内镜诊治问题,现将四川大学华西医院消化内镜中心2004年10月至2011年12月儿童和青少年胃镜一肠镜以及ERCP诊治的适应证、麻醉方式、诊治结果、并发症等相关临床资料分析如下。     

无痛消化道内镜检查的护理

目前,消化道内镜已广泛应用于消化道疾病的诊断治疗中,由于它的直观性好,诊断准确率高,尤其是胃镜肠镜已成为胃肠道疾病最重要的诊断方法,但有部分患者难以承受内镜对咽喉、胃肠的刺激,严重者不得不中止操作。我院自2001年开展无痛胃镜、无痛肠镜接受检查者164例,效果满意,现将护理问题讨论如下。1 资料与方法1.1 一般资料。164例检查者中,无痛胃镜106例(普通检查76例,息肉治疗17例,上消化道异物取出13例),无痛肠镜58例(普通检查43例,息肉治疗15例),男93例。女71例, 年龄7-78岁,多为儿童、老人及精神过度紧张普通胃肠镜检查难以成功者。2例因为食管入口处病变需取活检清醒状态下胃镜难以固定操作困难而采取了麻醉方式。     

新型冠状病毒肺炎疫情期间血液科病房的管理策略

总结了在新冠肺炎疫情期间血液科病房的护理管理策略,以保障患者、医护人员及社会安全,主要包括不断更新相关制度、加强控感培训、严格执行门禁管理、床位管理、环境管理、患者及家属管理、饮食管理及人员管理等有效措施,减少了血液科病房患者交叉感染的风险,自2020年1月23日—4月3日收入院的94例患者无一例感染新冠肺炎,同时获得了患者及家属的支持和理解,认为此管理方法值得其他护理单元借鉴。     

新冠肺炎疫情期间消化外科手术室优化管理实践

目的 探讨消化外科手术室新冠肺炎疫情条件下的优化管理方法.方法 西京医院新冠肺炎疫情期间的消化外科手术室管理措施主要包括优化患者流程管理、严格分区管理、手术室人员管理、环境安全管理、物资管理、做好手术患者的健康教育等,同时重视手术室护理人员的心理疏导,并加强人文关怀.结果 疫情期间消化外科手术室手术顺利开展.进行发热患...     

无痛胃镜下套扎治疗食管静脉曲张疗效分析

目的 研究无痛胃镜和普通胃镜下进行食管静脉曲张套扎治疗对患者影响对照.方法 182例肝硬化患者,共进行267例次内镜下套扎治疗,分成2组,普通内镜组115例次,无痛胃镜组152例次,分别观察两组术前、术中、术后生命体征,术中不良反应、出血情况、术后调查患者对内镜下套扎治疗的耐受情况及医师对手术的满意度,无痛胃镜组观察术前及术后7 d的肝功能及凝血酶原活动度变化.结果 无痛胃镜组和普通胃镜组术前、术中收缩压、舒张压相比、生命体征相比均无统计学意义(P>0.05);术中操作医师对食管蠕动及视野满意度无痛胃镜组明显高于普通胃镜组(P<0.01).结论 无痛胃镜下套扎治疗食管静脉曲张是一种安全、易被患者接受的治疗方法.     

新冠肺炎定点救治医院护理管理应急体系构建

目的 制定新冠肺炎定点救治医院应急护理管理策略,探讨其实施效果,为新冠肺炎定点医院的疫情防控护理工作提供建议和指导。方法 基于新冠肺炎定点救治医院病区筹备、医护人员防护用品穿脱程序培训、新冠定点医院相关护理常规和操作技术的培训、危重症患者的护理、医疗废弃物处理、合理排班、心理支持及后勤保障等方面实施疫情防控应急策略及护理管理。结果 2022年4月8日-6月5日,我院累计收治新冠肺炎阳性患者956例,其中重症203例,重症患者好转率(从重症转为普通型或轻型)达到97.8%。结论 新冠肺炎在上海流行期间,制定新冠肺炎定点救治医院护理管理策略、应急体系的构建有效地防止院内交叉感染的发生、有效地治愈重症患者和避免疫情地蔓延和扩散。     

新型冠状病毒肺炎疫情下普通病房的护理管理策略

面对新型冠状病毒肺炎疫情,一线抗疫科室备受关注。但作为满足人民群众日常诊疗需求的普通科室,做好院内感染预防、人员培训和物资管理同样也是护理管理者需要关注的重点。为做好疫情下普通病房的护理管理,通过文献回顾,结合临床护理管理实践经验,本文从患者管理、工作人员管理、日常环境和物体表面消毒管理、医疗废物管理、病室设施及物资管理和护理质量管理6个方面总结了新冠肺炎疫情下普通病房的护理管理策略,旨在为临床护理管理者提供参考。     

International digestive endoscopy network 2012: a patchwork of networks for the future

This special September issue of Clinical Endoscopy will discuss various aspects of diagnostic and therapeutic advancement of gastrointestinal (GI) endoscopy, explaining what is new in digestive endoscopy and why international network should be organized. We proposed an integrated model of international conference based on the putative occurrence of Digestive Endoscopy Networks. In International Digestive Endoscopy Network (IDEN) 2012, role of endoscopy in gastroesophageal reflux disease and Barrett's esophagus, endoscopy beyond submucosa, endoscopic treatment for stricture and leakage in upper GI, how to estimate the invasion depth of early GI cancers, colonoscopy in inflammatory bowel disease (IBD), a look into the bowel beyond colon in IBD, management of complications in therapeutic colonoscopy, revival of endoscopic papllirary balloon dilation, evaluation and tissue acquisition for indeterminate biliopancreatic stricture, updates in the evaluation of pancreatic cystic lesions, issues for tailored endoscopic submucosal dissection (ESD), endoluminal stents, management of upper GI bleeding, endoscopic management of frustrating situations, small bowel exploration, colorectal ESD, valuable tips for frustrating situations in colonoscopy, choosing the right stents for endoscopic stenting of biliary strictures, advanced techniques for pancreaticobiliary visualization, endoscopic ultrasound-guided biliopancreatic drainage, and how we can overcome the obstacles were deeply touched. We hope that IDEN 2012, as the very prestigious endoscopy networks, served as an opportunity to gain some clues for further understanding of endoscopic technologies and to enhance up-and-coming knowledge and their clinical implications from selected 25 peer reviewed articles and 112 invited lectures.     

新型冠状病毒肺炎疫情期间综合医院护理应急人员储备库的建立与管理

目的 总结新型冠状病毒肺炎疫情期间,综合医院基于信息网络技术建立与管理护理应急人员储备库的经验。 方法 调整组织管理架构;基于组建原则及流程建立护理应急人员储备库;基于医院信息平台实施应急人员基本信息的维护、新冠肺炎知识及相关技能的培训、实施多方位的心理支持及人文关怀,做好人员的应急储备工作。 结果 截止至2020年2月15日,共有553名护理人员入库,其中备岗260人,293人参与一线疫情防控工作。 结论 基于信息网络技术建立护理应急人员储备库,确保了疫情时期高效的人力调度及人员的动态管理,为后续灾害救援工作积累了经验。     

Endoscopic tumor diagnosis and treatment

The abstracts from this year's Digestive Disease Week (DDW) show that endoscopic is consistently playing a prominent role in current gastroenterology. The topic of tumor diagnosis and treatment overlaps considerably with other review areas - e. g., endoscopic ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), and colonoscopy. This review therefore focuses on the following topics: enhanced imaging, endoscopic mucosal resection (EMR), and palliative stent therapy. Endoscopy with tissue sampling is increasingly becoming an integral part of transitional research, in collaboration with molecular biologists and geneticists, among others. This role is unlikely to be challenged by any of the rapidly improving pure imaging modalities, and may well become a core role for endoscopy in the years to come. Abstracts from this category are not included in this overview.     

消化内镜在腹型过敏性紫癜早期诊断中的应用

目的分析成人腹型过敏性紫癜的消化内镜检查结果,为该病的早期诊断提供依据。方法对成人腹型过敏性紫癜的15例胃镜、3例结肠镜及2例胶囊内镜的检查结果进行分析。结果胃镜检查发现15例患者十二指肠黏膜散在大小不一的出血点、出血斑,3例十二指肠球部溃疡并出血,3例结肠镜检查均见黏膜水肿、出血点或出血斑,且以升结肠和回肠末端为著。2例胶囊内镜结果显示小肠黏膜水肿,散在黏膜糜烂和片状出血斑。活检病理检查见黏膜肌组织内大量中性粒细胞及淋巴细胞浸润。结论消化内镜检查对于腹型过敏性紫癜的早期诊断具有较高价值。     

Changes in endoscopic patterns before and during COVID-19 outbreak: Experience at a single tertiary center in Korean

BACKGROUNDThe surge of coronavirus disease 2019 (COVID-19) patients has markedly influenced the treatment policies of tertiary hospitals because of the need to protect medical staff and contain viral transmission, but the impact COVID-19 had on emergency gastrointestinal endoscopies has not been determined.AIMTo compare endoscopic activities and analyze the clinical outcomes of emergency endoscopies performed before and during the COVID-19 outbreak in Daegu, the worst-hit region in South Korea.METHODSThis retrospective cohort study was conducted on patients aged ≥ 18 years that underwent endoscopy from February 18 to March 28, 2020, at a tertiary hospital in Daegu. Demographics, laboratory findings, types and causes of emergency endoscopies, and endoscopic reports were reviewed and compared with those obtained for the same period in 2018 and 2019.RESULTSFrom February 18 to March 28, a total of 366 emergent endoscopic procedures were performed: Upper endoscopy (170, 50.6%), endoscopic retrograde cholangiopancreatography (113, 33.6%), and colonoscopy with sigmoidoscopy (53, 15.8%). The numbers of procedures performed in 2018 and 2019 dropped by 48.8% and 54.8%, respectively, compared with those in 2020. During the COVID-19 outbreak, the main indications for endoscopy were melena (36.7%), hematemesis (30.6%), and hematochezia (10.2%). Of the endoscopic abnormalities detected, gastrointestinal bleeding was the most common: 39 cases in 2018, 51 in 2019, and 35 in 2020.CONCLUSIONThe impact of COVID-19 is substantial and caused dramatic reductions in endoscopic procedures and changes in patient behaviors. Long-term follow-up studies are required to determine the effects of COVID-19 induced changes in the endoscopy field.     

2019版《中国消化内镜诊疗相关肠道准备指南》解读

随着内镜技术的发展和普及,肠镜检查的重要性进一步突显,肠道准备作为肠镜检查的前提条件显得尤为重要。为进一步改进我国内镜检查前肠道准备的方法,提高内镜检查的质量,结合我国实际情况,中国医师协会内镜医师分会消化内镜专业委员会联合中国抗癌协会肿瘤内镜学专业委员会对旧版指南进行了更新。本文对2019版《中国消化内镜诊疗相关肠道准备指南》的更新内容进行解读,以期更好地加深内镜医护人员对《新指南》的认知和理解,指导患者进行肠道准备,从而最大程度提高肠镜诊疗效果,更大程度的使患者获益。     

Methods of disinfecting endoscopic material: results of an international survey

A questionnaire on the methods of cleaning and disinfecting endoscopic equipment was mailed to 120 centers in Western Europe. Seventy-four questionnaires (61%) were returned. The centers were classified into three groups according to the number of endoscopic procedures performed per year. This survey has shown that precautions are more rigid in specialized centers than in units doing fewer than 1,500 endoscopic investigations a year. Complete disinfection is done by almost all the centers after ERCP in infected patients or in the case of HBsAg and HIV-positive patients, but only by 70% of centers after completion of endoscopies performed in patients with gastrointestinal hemorrhage and unknown immunological status. After endoscopic examination performed in presumably non-infected subjects, complete disinfection is not done in any center after gastroscopy, in 13% after colonoscopy and in 30% after ERCP. Continued education of endoscopic personnel and greater availability of adequate endoscopic equipment is mandatory for minimizing the risk of endoscopy-related infections.     

Sketch of international digestive endoscopy network 2012 meeting: overview

International Digestive Endoscopy Network (IDEN) is an international meeting covering scientific subjects of diverse topics about upper gastrointestinal (GI) endoscopy, colonoscopy, endoscopic ultrasonography, and PB endoscopy. IDEN is organized by Korean Society of Gastrointestinal Endoscopy and the Korean Gastrointestinal Endoscopy Research Foundation, and took its first step in 2011 in Seoul, Korea. IDEN inaugurated a new era of diagnostic and therapeutic GI endoscopy. IDEN 2012 was designed to offer participants from all over the world with opportunities to share up-to-date knowledge about basic and clinical aspects of GI endoscopy and to engage in in-depth discussion with worldwide well-known experts. During the 2 days of meeting, there were 62 invited lectures, 28 case-based discussions, 20 video lectures, and 6 breakfast with the experts. There were a total of 598 participants registered from 12 countries, including Asian countries, Europe, and USA as well as Korea.     

新型冠状病毒肺炎疫情防控期间急性梗阻性化脓性胆管炎一例诊治体会

新型冠状病毒肺炎（COVID-19）疫情暴发以来,全国各地医务人员众志成城,打响了一场轰轰烈烈的疫情阻击战。作为非定点医院、非隔离病区的普通外科,如何在疫情防控期间既要做好防护工作、又要及时救治急危重患者的生命,是我们当前面临的一项艰巨任务。本文通过介绍一例72岁老人的急性梗阻性化脓性胆管炎的诊治过程,强化术前检查的针对性和特殊性,分析急诊手术的必要性和紧迫性,总结腹腔镜经胆囊管胆总管探查取石术（LTCBDE）的适应证和技术改进,同时探讨COVID-19疫情防控期间急诊手术的防护要点和注意事项,以期为疫情防控期间的普通外科手术决策提供借鉴。     

新型冠状病毒肺炎疫情期间“1移2精3零”预检分诊管理

目的 探索新型冠状病毒肺炎（简称新冠肺炎）疫情期间的预检分诊管理模式,以期减少疑似患者漏检、院内交叉感染和提高患者就医满意度。 方法 将预检分诊关口外移,分别在门诊、急诊、住院部关键入口搭建帐篷,设置预检分诊点;加强预检分诊人员及物品的精细化管理和预检分诊流程及信息的精准化管理。 结果 2020年1月25日—2月20日,累计预检分诊37 698例次,其中新冠肺炎发热门诊患者301例,普通发热门诊患者639例,新冠肺炎疑似病例收住隔离区160例,确诊新冠肺炎患者并转诊3例。在此期间,新冠肺炎疑似患者零漏检,院内交叉感染零发生,患者及家属零投诉。 结论 “1移2精”预检分诊管理模式行之有效,在新冠肺炎疫情期间起到控制疫情传播的作用,将来可推广和应用于其他传染病疫情。