实用老年医学

实用老年医学 ›› 2021, Vol. 35 ›› Issue (7): 722-726.doi: 10.3969/j.issn.1003-9198.2021.07.015

• 临床研究 • 上一篇    下一篇

微信平台随访促进老年早期胃癌及癌前病变内镜黏膜下剥离术后病人随访依从性的研究

许真真, 姜经伟, 徐桂芳, 李雯, 杨华, 滕玉芳, 杨金萍, 陈湘玉   

  1. 210008 江苏省南京市,南京大学医学院附属鼓楼医院消化内科(许真真,姜经伟,徐桂芳,李雯,杨华,滕玉芳,杨金萍);护理部(陈湘玉)
  • 收稿日期:2020-08-23 出版日期:2021-07-20 发布日期:2021-08-02
  • 基金资助:
    国家自然科学基金资助项目(81572338);江苏省“六大人才高峰”资助项目(2015-WSN-078)

Study on follow-up via WeChat to promote compliance of elderly patients with early gastric cancer and precancerous lesions after endoscopic submucosal dissection

XU Zhen-zhen, JIANG Jing-wei, XU Gui-fang, LI Wen, YANG Hua, TENG Yu-fang, YANG Jin-ping   

  1. Department of Nursing,Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008,China
  • Received:2020-08-23 Online:2021-07-20 Published:2021-08-02

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摘要： 目的 探讨微信平台随访对老年早期胃癌及癌前病变内镜黏膜下剥离术(ESD)后病人随访依从性的影响。 方法 选择2019年1～9月因早期胃癌及癌前病变在南京大学医学院附属鼓楼医院接受ESD治疗的老年病人307例作为研究对象,6月1日前的病例纳入对照组(166例),实施电话随访;之后的病例纳入观察组(141例),实施微信平台随访。分析2组术后咨询、定期内镜复查及Hp根除治疗依从性,并记录观察组及医务人员的微信平台随访满意度。 结果 老年早期胃癌及癌前病变ESD术后病人对病理报告(25.1%)、复查挂号(24.1%)、饮食(16.9%)、用药(15.0%)、术后不适(14.0%)等咨询频率较高,且咨询问题随距离手术的时间而变化。观察组术后3、6个月内镜复查依从性高于对照组(71.6%比57.8%,38.3%比27.7%),Hp根除治疗依从性高于对照组(70.3%比46.9%),差异均有统计学意义(P<0.05)。单因素分析显示,微信平台随访及居住在城镇地区可促进病人定期内镜复查依从性(P<0.01),通过微信平台随访及存在肿瘤家族史者Hp根除依从性较好(P<0.05)。此外,所有参与微信平台随访的医务人员和87.9%的病人对微信平台随访表示满意。 结论 微信平台随访可促进老年早期胃癌及癌前病变ESD术后病人定期内镜复查及Hp根除治疗依从性,且医患满意度较高。

关键词: 早期胃癌, 癌前病变, 微信, 内镜黏膜下剥离术, 随访依从性

Abstract: Objective To investigate the effect of follow-up via WeChat on the compliance of the elderly patients with early gastric cancer or precancerous lesions after endoscopic submucosal dissection (ESD). Methods A total of 307 elderly patients with early gastric cancer or precancerous lesions who underwent ESD from January to September 2019 in our hospital were enrolled. The patients before June 1, 2019 were assigned into the control group(n=166) receiving routine outpatient service and telephone follow-up, the patients after June 1,2019 were assigned into observation group(n=141) receiving WeChat follow-up.Postoperative consultation, compliance of regular endoscopic reexamination and Hp eradication were analyzed between the two groups. The follow-up satisfaction of WeChat platform in the observation group and medical staff was recorded. Results The pathological results (25.1%), registration for reexamination (24.1%), diet (16.9%), medication (15.0%), and discomfort response (14.0%) were the most common questions consulted by the patients with early gastric cancer or precancerous lesions after ESD . In addition,the questions of consultation were changed with the time after surgery. The compliance of endoscopic reexamination 3, 6 months after surgery and Hp eradication in the observation group were significantly higher than those in the control group(71.6% vs 57.8%,38.3% vs 27.7%,70.3% vs 46.9%,respectively,all P<0.05). Univariate analysis showed that follow-up of WeChat platform and living in urban areas could improve the patients' compliance with regular endoscopic reexamination (P<0.01). The patients with WeChat platform follow-up and family history of tumor showed better compliance with Hp eradication (P<0.05). All medical staffs and 87.9% of the patients were satisfied with the follow-up by WeChat platform. Conclusions The follow-up via WeChat can promote the compliance of the elderly patients with early gastric cancer or precancerous lesions after ESD with high satisfaction of the patients and the medical staffs.

Key words: early gastric cancer, precancerous lesions, WeChat, endoscopic submucosal dissection, follow-up compliance

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