对于患有食道食物球体冲击的患者的末端镜后护理:基于人口的多中心队列研究
Howard Guo1, Patrick Hamilton1, Edwin Enns2
1Division of Internal Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
The American journal of gastroenterology
|July 6, 2023
概括
四分之一的患有食道食物球体冲击 (FBI) 的患者没有得到适当的内镜后护理. 在最初的内镜检查中未能确定潜在的食道病理,这增加了不充分的随访的风险.
科学领域:
- 胃肠病学 胃肠病学
- 食道疾病 食道疾病
- 改善医疗质量 改善医疗质量
背景情况:
- 食道食物球体冲击 (FBI) 是一种常见的紧急情况,需要迅速进行内镜解压.
- 最佳的管理超越了初始内镜,包括关键的随访和治疗潜在的食道疾病.
- 不充分的术后护理可能导致不良结果和错过的诊断.
研究的目的:
- 评估内镜术后护理对患有 FBI 的患者的适当性.
- 为了确定患者,医生和系统相关的因素,有助于失去随访.
- 评估识别潜在的食道病理对护理质量的影响.
主要方法:
- 追溯性,基于人群的多中心队列研究.
- 对2016-2018年为FBI进行内镜检查的成年患者的分析.
- 适当护理的定义包括后续访问,调查或治疗;用于识别不适当护理预测因素的多变量逻辑回归.
主要成果:
- 25.2%的患者没有得到适当的内镜后护理.
- 在索引内镜检查中未能确定潜在的食道病理与不适当的随访有很强的关联 (aOR 7.28).
- 随访显示,22.3%的患者的诊断变化,包括3例食道癌症的新病例.
结论:
- 很大一部分患有 FBI 的患者在内镜后得到了不够优的护理.
- 早期发现潜在的食道病理对于确保适当的随访和治疗至关重要.
- 改善护理途径可以提高患有食道食物球体影响的患者的治疗结果.
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