关键词： Inflammatory bowel disease   costs   eHealth   faecal calprotectin  

摘要： Background Costs of using eHealth in inflammatory bowel disease (IBD) management has only been assessed for short follow-up periods. The primary aim was to compare the direct costs of eHealth (cases) relative to standard care (matched controls) for IBD during three years of follow-up. Methods The study design was a retrospective, registry-based follow-up study of patients diagnosed with IBD two years prior, and three years subsequent, to their enrolment in eHealth. Cases were matched 1:4 with controls receiving standard care based on diagnosis, gender, biologics (yes/no) and age (+/- 5 years). Results We identified 116 cases (76 (66%) with ulcerative colitis (UC) and 40 (34%) with Crohn's disease (CD)) and matched them with 433 controls. IBD-related outpatient costs were only significantly higher for cases in the year of their inclusion in eHealth (euro2,949 vs. euro1,621 per patient, p =.01). Mean IBD-related admission costs tended to fall after enrolment in eHealth, with mean admission costs per patient at year 3 of follow-up of euro74 for cases and euro383 for controls (p = .02). Linear extrapolation of the reduction in costs beyond year 3 after enrolment in eHealth revealed that eHealth would be cost neutral or saving, relative to standard care, from year 4. Conclusion IBD-related outpatient costs in both groups were similar and only significantly higher for cases in the year of their enrolment in eHealth, with admission costs typically falling after a patient's inclusion in eHealth. Estimation revealed eHealth to be cost neutral or saving from year 4.

关键词： Inflammatory bowel disease   quality of care   quality of life   telemedicine   EasyMICI–   MaMICI(®)  

摘要： Background Telemedicine has shown promising results in the follow up of patients with inflammatory bowel disease. This study compared quality of life and disease activity in patients with inflammatory bowel disease monitored using a telemedicine platform versus standard care. Methods In this prospective multicenter study, patients with active inflammatory bowel disease were randomized to EasyMICI-MaMICI(R) telemedicine platform or standard care. The main objective was to assess the efficacy of the software platform, as measured by quality of life and quality of care. Secondary outcomes were changes in the use of healthcare resources, and patient satisfaction in the MaMICI group. Results Fifty-four patients were enrolled (November 2017-June 2018);59.3% had Crohn's disease and 40.7% ulcerative colitis. Forty-two patients received biologics at inclusion. After 12 months, a significant improvement in quality of life was observed with MaMICI versus standard care, with mean (standard deviation) changes from baseline of 14.8 (11.8) vs 6.3 (9.7) in the SIBDQ scores and 18.5 (18.7) vs 2.4 (8.3) in the EuroQol 5 D-3L questionnaire scores (both p <= .02). Disease activity was similar in both treatment groups. Use of MaMICI slightly reduced healthcare utilization versus controls (mean gastroenterologist consultations 2.2 vs 4.1;p = .1308). Overall satisfaction with MaMICI was high (mean score 7/10), and 46.2% of remaining patients in the MaMICI group continued to use the platform until 12 months. Conclusion Significant improvement in quality of life and overall satisfaction with this telemedicine platform, indicates that further evaluation of EasyMICI-MaMICI in larger numbers of patients with inflammatory bowel disease is warranted.

关键词： Inflammatory bowel disease   Oral administration   Nano-delivery systems   Mechanisms   Targeting strategies  

摘要： Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder of gastrointestinal tract with rising incidence. Established treatments of IBD are characterized by significantly adverse effects, insufficient therapeutic efficacy. Employing the oral nano-drug delivery systems for targeted therapy is capable of effectively avoiding systematic absorption and increasing local drug concentration, consequently leading to decreased adverse effects and improved therapeutic outcomes. This review gives a brief profile of pathophysiological considerations in terms of developing disease-directed drug delivery systems, then focuses on mechanisms and strategies of current oral nano-drug delivery systems, including size-, enzyme-, redox-, pH-, ligand-receptor-, mucus-dependent systems, and proposes the future directions of managements for IBD.

关键词： 红蓝光治疗   中药灌洗   肛肠疾病术后   疼痛   影响  

摘要： 了解红蓝光治疗联合中药熏洗的方法应用于老年肛肠疾病患者术后疼痛患者的作用,分析红蓝光治疗及中药灌洗的有效性。 方法:选取当地中医医院里于 2018 年 9 月 ~2020 年 12 月入院治疗的因需进行手术的老年肛肠疾病患者 40 例,根据就诊于此医院的先后顺序对研究对象进行随机分组,共分为两组。经诊断后确诊为痔疮,对全部患者行手术治疗,术后继续完善药物治疗及基本护理,同时进行中药灌洗,一组为基础治疗组,另一组为红蓝光治疗组,各纳入 20 例。 基础治疗组的已行痔疮切除术的病患采用基础护理及止痛药物干预,红蓝光治疗组内的行痔疮切除术的老年患者则通过红蓝光照射的方案进一步行康复理疗,同时与基础组一样定期应用止痛药物,如布洛芬,治疗 2 周后进行创面疼痛及睡眠治疗的评估,衡量二组老年患者疗效。 结果:术后 2 周,红蓝光组创面疼痛的评分低于基础理疗组,差异有统计学意义(P<0.05);睡眠质量评分较对照组降低,治疗效果好,差异有统计学意义(P<0.05)。 结论:中医治疗手段在治疗老年肛肠疾病术后患者方面,效果显著,有助于老年患者术后创面疼痛缓解,使老年患者睡眠质量大大改善,疾病预后效果良好。

关键词： 穴位敷贴   中药熏洗   肛肠疾病   术后疼痛  

摘要： 目的探讨中药熏洗联合穴位敷贴治疗对肛肠疾病术后疼痛的效果和安全性。方法60例肛肠疾病术后疼痛患者,随机分为观察组和对照组,各30例。对照组给予穴位敷贴治疗,观察组在对照组基础上联合中药熏洗治疗。比较两组治疗前后视觉模拟评分法(VAS)评分及换药后疼痛持续时间、创面愈合时间、临床疗效、不良反应发生情况。结果术后第1天,观察组和对照组换药后疼痛持续时间分别为(3.26±0.72)、(3.14±0.69)h,两组比较差异无统计学意义(P>0.05);术后第3、5、7天,观察组换药后疼痛持续时间分别为(2.39±0.67)、(1.87±0.54)、(1.24±0.36)h均明显短于对照组的(2.87±0.59)、(2.31±0.61)、(1.72±0.43)h,差异有统计学意义(P<0.05)。观察组创面愈合时间为(13.06±4.26)d,短于对照组的(20.65±5.37)d,差异有统计学意义(P<0.05)。治疗前,两组VAS评分比较,差异无统计学意义(P>0.05);治疗后,观察组和对照组VAS评分分别为(3.83±0.86)、(4.57±0.98)分均显著低于治疗前的(7.63±1.22)、(7.54±1.06)分,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论对肛肠疾病术后疼痛患者进行中药熏洗联合穴位敷贴治疗可明显改善疼痛情况,提高治疗效果,疼痛持续时间明显缩短,加速创面愈合,并且具有较高安全性,具有临床推广应用价值。

关键词： 肛肠疾病   电子直乙肠镜   高龄人群   筛查  

摘要： 目的了解社区高龄人群肛肠疾病的发生情况,同时评价电子直乙肠镜在肛肠疾病筛查中的作用。方法对北京市西城区西长安街区60~74岁常住人口采用填写危险因素评估调查问卷的方法完成初筛,将初筛结果阳性者列为高危人群,给予电子直乙肠镜检查进行诊断性复筛。结果共有4782位筛查对象,实际参加初筛4347人,初筛阳性2997人(阳性率为68.9%),其中参加电子直乙肠镜检查2312人,顺应率为77.1%。电子直乙肠镜检查共检出各类肛肠疾病2275人,其中痔1311人(56.7%)、结直肠息肉458人(19.8%)、肛乳头肥大154人(6.7%)、直肠炎147人(6.4%)、肛裂103人(4.4%)、肛瘘52人(2.2%)、直肠黑变病33人(1.4%)、疑似直肠癌17人(0.7%);未见异常37人(1.6%)。男性人群中结直肠息肉、直肠炎、肛瘘的检出率要高于女性(P<0.05),而痔、肛乳头肥大、肛裂、直肠黑变病的检出率则是女性高于男性(P<0.05)。结论从本研究结果看,电子直乙肠镜作为筛查工具,具有操作简便、受检者依从性好、复筛顺应率高等特点,适用于社区高龄居民肛肠疾病的大范围筛查。

关键词： Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Indeterminate colitis   Epidemiology   Endoscopy  

摘要： BACKGROUND The incidence and prevalence of inflammatory bowel disease(IBD)vary between regions but have risen globally in recent decades.A lack of data from developing nations limits the understanding of IBD *** To perform a follow-up review of IBD epidemiology in the Tuzla Canton of Bosnia-Herzegovina during a 10-year period(2009-2019).METHODS We prospectively evaluated the hospital records of both IBD inpatients and outpatients residing in Tuzla Canton for the specified period of time between January 1,2009 and December 31,*** all our patients had undergone proximal and distal endoscopic evaluations at the hospital endoscopy unit,we used the hospital’s database as a primary data source,alongside an additional cross-relational search of the *** adult and pediatric patients were included in the *** were grouped by IBD type,phenotype,age,and *** rates were calculated with age standardization using the European standard *** in incidence and prevalence were evaluated as a 3-year moving average and average annual percentage change *** During the 10-year follow-up period,651 patients diagnosed with IBD were monitored(of whom 334,or 51.3%,were males,and 317,or 48.7%,were females).Of all the patients,346(53.1%)had been diagnosed with ulcerative colitis(UC),292(44.9%)with Crohn’s disease(CD),and 13(2%)with indeterminate colitis(IC).We observed 440 newly diagnosed patients with IBD:240(54.5%)with UC,190(43.2%)with CD,and 10(2.3%)with *** mean annual crude incidence rates were found to be 9.01/100000 population for IBD[95%confidence interval(CI):8.17-9.85],with 4.91/100000(95%CI:4.29-5.54)for UC and 3.89/100000(95%CI:3.34-4.44)for *** IBD prevalence in 2019 was 146.64/100000(95%CI:128.09-165.19),with 77.94/100000(95%CI:68.08-87.70)for UC and 65.77/100000(95%CI:54.45-74.1)for *** average annual IBD percentage change was 0.79%(95%CI:0.60-0.88),with-2.82%(95%CI:-2.67 to-2.97)for UC and

关键词： 住院费用   肛肠疾病   影响因素  

摘要： 目的:分析肛肠疾病患者的住院总费用及其影响因素,为优化医疗资源分布、减轻疾病直接经济负担提供参考。方法:采用描述性分析和Kruskal-Wallis H检验,对贵州省某三甲医院2014-2017年14236例肛肠疾病患者的住院总费用进行影响因素分析,并运用多重线性回归调查西成药费、材料费、手术费、治疗费、化验费、检查费、中成药费、床位费、中草药费、护理费、诊查费对住院总费用的影响。结果:结直肠癌患者的住院总费用最高,中位数为50048元;直肠脱垂、肛瘘、痔、肛周脓肿、肛裂及肛乳头瘤患者的住院总费用中位数在9000至11000元间;肠息肉患者及结直肠癌术后治疗患者的住院总费用最低,中位数为7600元左右;年龄、住院天数、诊断、支付方式对肛肠疾病患者住院总费用产生的差异存在统计学意义(P<0.05);对住院总费用影响较大的费用是西成药费、治疗费、材料费、手术费、中成药费(P<0.05)。结论:肛肠疾病患者疾病直接经济负担较重,应重视肛肠疾病防治,采取综合措施,合理控制疾病直接经济负担。

关键词： 牛   胃肠疾病   预防   治疗  

摘要： 胃肠疾病是牛的高发疾病,轻则会影响牛的生长发育,重则会导致牛死亡。本文主要对牛常见的几种胃肠疾病的预防及治疗展开探讨,供参考。