基于患者报告结局的结构化随访在早期胃癌内镜黏膜下剥离术患者中的应用  

Structured follow-up based on patient report outcome in patients undergoing endoscopic submucosal dissection for early gastric cancer

作　　者：滕玉芳[1] 杨华[1] 徐桂芳[1] 曹燕平[1] 于铃 TENG Yufang;YANG Hua;XU Guifang;CAO Yanping;YU Ling(Department of Gastroenterology,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院消化内科,江苏南京210008

出　　处：《中国临床研究》2024年第2期307-311,共5页Chinese Journal of Clinical Research

基　　金：国家自然科学基金资助项目(82170548);江苏省省重点研发计划(社会发展)面上项目(BE2021601)。

摘　　要：目的探究基于患者报告结局(PRO)的结构化随访在早期胃癌内镜黏膜下剥离术(ESD)患者中的应用效果。方法纳入2022年1月至12月南京大学医学院附属鼓楼医院消化内科收治的198例早期胃癌ESD治疗患者为研究对象,将2022年6月前收治的患者纳入对照组,实施常规随访,将2022年6月后收治的患者纳入观察组,实施基于PRO的结构化随访。比较分析两组患者的PRO情况,术后半年内内镜复查率、Hp阳性根除率,患者满意度及观察组医务人员PRO态度。结果观察组患者的健康生活习惯养成报告表单(74.07%vs 19.66%)、内镜复查报告表单(61.73%vs 29.91%)及Hp根除治疗报告表单(72.72%vs 24.14%)的完成情况优于对照组(P<0.05)。观察组半年内内镜按时复查率高于对照组(69.14%vs 45.30%,P<0.05),Hp阳性患者Hp根除治疗的依从性高于对照组(81.82%vs 27.59%,P<0.05)。观察组患者满意度高于对照组(P<0.05)。观察组医务人员PRO态度处于中上水平。结论基于PRO的结构化随访系统可有效提升早期胃癌ESD术后患者的PRO情况、术后半年内镜复查率、Hp阳性根除率、患者满意度,得到大部分医务人员的支持。Objective To explore the application effect of structured follow-up based on patient-reported outcome(PRO)in patients undergoing endoscopic submucosal dissection(ESD)for early gastric cancer.Methods A total of 198 patients with early gastric cancer treated by ESD in the Department of Gastroenterology,Drum Tower Hospital Affiliated to Medical School of Nanjing University from January 2022 to December 2022 were selected as the research subjects.Patients admitted before June 2022 were included in the control group and received routine follow-up,while those admitted after June 2022 were included in the experimental group and received structured follow-up based on PRO.The PRO situation,endoscopic reexamination rate within half a year after surgery,Hp eradication rate,patient satisfaction,and attitudes of medical staff towards patient report outcome in the experimental group were compared and analyzed.Results The completion rates of the health habits formation report form(74.07%vs 19.66%),endoscopy follow-up report form(61.73%vs 29.91%),and Hp eradication therapy report form(72.72%vs 24.14%)were superior in the observation group compared to the control group(P<0.05).The observation group had a higher rate of on-time endoscopic follow-up within six months compared to the control group(69.14%vs 45.30%,P<0.05),and the compliance of Hp-positive patients with Hp eradication therapy was higher than that of the control group(81.82%vs 27.59%,P<0.05).Patient satisfaction in the observation group was higher than that in the control group(P<0.05).The healthcare personnel in the observation group exhibited a relatively high level of PRO attitude.Conclusion Structured follow-up based on PRO can effectively enhance PRO,endoscopy follow-up rates,Hp eradication rates,and patient satisfaction in patients after early gastric cancer ESD,receiving support from the majority of healthcare personnel.

关 键 词：胃癌 内镜黏膜下剥离术 患者报告结局 结构化随访 健康管理 

分 类 号：R473.5[医药卫生—护理学]