约10%~30%的新发结直肠癌患者会出现急性肠梗阻，传统急诊手术治疗存在术后并发症高、死亡率高、生存质量低等不足。肠道支架置入联合限期手术作为一种新型治疗策略，展现出显著优势。肠道支架可迅速解除梗阻，改善患者症状，降低手术风险，为肿瘤微创切除创造条件，同时为新辅助化疗提供可能，但其潜在并发症如出血、移位、再梗阻及肠穿孔等也不容忽视，且长期安全性及对肿瘤结局的影响尚不明确。文章综述了肠道支架治疗梗阻性结直肠癌的治疗现状、争议及研究进展，旨在为临床研究和实践提供参考依据。
Approximately 10% to 30% of patients with newly diagnosed colorectal cancer present with acute intestinal obstruction．Traditional emergency surgical intervention is characterized by high rates of postoperative complications，elevated mortality，and diminished quality of life．Combined stent and curative elective surgery（CSCES）has emerged as a novel therapeutic strategy，exhibiting significant clinical benefits．Intestinal stenting can rapidly alleviate obstruction，thereby improving patient symptoms，reducing surgical risks，and facilitating minimally invasive tumor resection．Additionally，it provides an opportunity for neoadjuvant chemotherapy．However，potential complications，including bleeding，stent migration，recurrent obstruction，and intestinal perforation，must be carefully considered．Moreover，the long-term safety and impact on oncologic outcomes remain to be elucidated．This review aims to provide a comprehensive overview of the current status，controversies，and recent advancements in the use of intestinal stents for the treatment of obstructive colorectal cancer，with the goalof informing clinical research and practice．
目的 修订肺癌患者联合药物治疗间歇期症状评估问卷，并评价其信效度。方法 以中文版安德森症状评估量表及肺癌特异性模块为基础，经文献分析、专家会议和认知性访谈形成测试版问卷。于2023年10-12月便利选取福州、莆田2所三级甲等医院278例肺癌患者进行调查，评价其信效度及偏倚风险。结果 修订后问卷含7个症状系统、60个条目，跳转式作答后实际作答21个条目。总问卷Cronbach's α系数为0.856，各维度为0.639～0.747；内容效度指数为0.81。验证性因子分析显示模型拟合尚可（χ2/df=2.366，RMSEA=0.070，CFI=0.858），各维度因子载荷、组合信度及平均方差提取量均达到可接受标准，区分效度良好。COSMIN-RoB评价结果为良好。结论 该问卷信效度良好，可用于评估肺癌患者联合药物治疗间歇期症状严重程度。
Objective To revise the Symptom Assessment Questionnaire for Lung Cancer Patients During Combined Drug Therapy Intervals and evaluate its reliability and validity. Methods Based on the Chinese version of the M. D. Anderson Symptom Inventory and its lung cancer-specific module, a preliminary questionnaire was developed through literature review, expert panel discussions, and cognitive interviews. From October to December 2023, a convenience sample of 278 lung cancer patients was recruited from two tertiary hospitals in Fuzhou and Putian, China. Reliability, validity, and risk of bias were evaluated. Results The revised questionnaire comprised seven symptom-system domains and 60 items, with 21 items completed through a skip-logic design. The overall Cronbach's α coefficient was 0.856, and the coefficients for each domain ranged from 0.639 to 0.747. The content validity index of the questionnaire was 0.81. Confirmatory factor analysis demonstrated an acceptable model fit (χ2/df = 2.366, RMSEA = 0.070, CFI = 0.858). Factor loadings, composite reliability, and average variance extracted of all domains met acceptable standards, indicating good discriminant validity. The overall risk of bias was rated as good according to the COSMIN Risk of Bias checklist. Conclusion The revised questionnaire demonstrated satisfactory reliability and validity and can be used to assess symptom severity in lung cancer patients during combined drug therapy intervals.
目的 编制适用于老年人群的衰弱综合征中医评估量表并检验其信度与效度。方法 通过文献研究及《中华医典》检索构建条目池，采用4轮德尔菲专家咨询及预调查筛选条目形成初量表；便利抽取300例老年患者行横断面调查，以Fried表型衰弱量表为校标，进行项目分析、Cronbach’s α系数、探索性因子分析及ROC曲线分析。 结果 经条目筛选最终形成含5个核心症状条目（表A）及38个证候条目（表B）的量表。表A校标关联效度r=0.929（P＜0.05），AUC=0.957，灵敏度0.949，特异度0.859；表A+B校标关联效度r=0.648（P＜0.05），AUC=0.827，灵敏度0.606，特异度0.911；总量表Cronbach's α=0.872。结论 所研制的衰弱综合征中医量表信效度良好，可用于老年人衰弱状态筛查及中医证型判别。
Objective: To develop a Traditional Chinese Medicine (TCM) assessment scale for frailty syndrome in the elderly and to evaluate its reliability and validity. Methods: An item pool was constructed through literature review and searches of the *Chinese Medical Canon*. A preliminary scale was developed through four rounds of Delphi expert consultation and a pilot survey. A cross-sectional survey was conducted using a convenience sample of 300 elderly patients. Using the Fried Phenotypic Frailty Scale as the gold standard, item analysis, Cronbach’s α coefficient, exploratory factor analysis, and ROC curve analysis were performed. Results: After item screening, the final scale comprised 5 core symptom items (Table A) and 38 syndrome items (Table B). For Table A, the criterion-related validity was r = 0.929 (P < 0.05), AUC = 0.957, sensitivity = 0.949, and specificity = 0.859; Table A+B showed a test-retest reliability of r = 0.648 (P < 0.05), an AUC of 0.827, a sensitivity of 0.606, and a specificity of 0.911; the total scale had a Cronbach’s α of 0.872. Conclusion: The developed Traditional Chinese Medicine (TCM) frailty syndrome scale demonstrates good reliability and validity and can be used for screening frailty in the elderly and for distinguishing TCM syndrome patterns.
【摘要】目的：探讨多元化健康宣教在幽门螺旋杆菌（Hp）感染碳13（13C）呼气试验筛查中的应用效果。方法：将2024年5月~2026年4月至我院体检科进行无痛胃肠镜检查后，结果提示Hp阳性的300例患者作为研究对象，开展前瞻性临床试验。经数字表法将入组患者随机列为常规组和试验组，每组150例。两组患者均行13C呼气试验，常规组检查前实施常规健康宣教，试验组检查前实施多元化健康宣教，比较两组患者的心理状态，准备情况，检查情况及整体满意度。结果：试验组的疾病不确定感（MUIS）评分、广泛性焦虑量表-7（GAD-7）评分均低于常规组（t=7.644，10.923；P＜0.05）。试验组的药物停用依从率、饮食依从率、空腹依从率分别92.00%（138/150）、93.33%（140/150）、96.67%（145/150），均高于常规组[80.00%（120/150）、81.33%（122/150）、85.33%（128/150）]（x2=8.970，9.763，11.762；P＜0.05）。试验组的吹气一次成功率、肺泡气样本质量达标率、检查完成率、检查结果准确率分别为94.67%（142/150）、94.00%（141/150）、96.67%（145/150）、96.00%（144/150），均高于常规组[82.67%（124/150）、83.33%（125/150）、84.67%（127/150）、84.00%（126/150），]（x2=10.748，8.492，12.763，12.000；P＜0.05）。试验组的心理舒适、信息获取、检查流畅、结果可靠满意度评分均高于常规组（t=5.279，4.625，4.592，5.729；P＜0.05）。结论：多元化健康宣教可改善Hp感染患者的心理状态，并优化13C呼气试验的准备情况、检查情况，对提升检查结果准确性及患者满意度均有积极影响
[Abstract]Objective:Exploring the application effect of diversified health education in screening for Hp infection with 13C breath test.Methods:A prospective clinical trial will be conducted on 300 patients who were found to be Hp positive after undergoing painless gastroscopy in our hospital from May 2024 to April 2026. The enrolled patients were randomly divided into a control group and an experimental group using a numerical table method, with 150 cases in each group. Both groups of patients underwent 13C breath tests. The routine group received routine health education before the examination, while the experimental group received diversified health education before the examination. The psychological status, preparation, examination results, and overall satisfaction of the two groups of patients were compared.Results:Compare to the control group,the experimental group had lower MUIS scores and GAD-7 scores (t=7.644，10.923; P<0.05). The medication discontinuation compliance rate, dietary compliance rate, and fasting compliance rate of the experimental group were 92.00% (138/150), 93.33% (140/150), and 96.67% (145/150), respectively, all higher than those of the conventional group [80.00% (120/150), 81.33% (122/150), 85.33% (128/150)] (x2=8.970，9.763，11.762; P<0.05). The success rate of one-time blowing, the quality compliance rate of alveolar gas samples, the completion rate of examination, and the accuracy of examination results in the experimental group were 94.67% (142/150), 94.00% (141/150), 96.67% (145/150), and 96.00% (144/150), respectively, which were higher than those in the conventional group [82.67% (124/150), 83.33% (125/150), 84.67% (127/150), 84.00% (126/150)] (x2=10.748，8.492，12.763，12.000; P<0.05). Compare to the control group,the experimental group had higher satisfaction scores of psychological comfort, information acquisition, smooth examination, and reliable results (t=5.279，4.625，4.592，5.729; P<0.05).Conclusion:Diversified health education can improve the psychological state of Hp infected patients, optimize the preparation and examination of 13C breath tests, and have a positive impact on improving the accuracy of examination results and patient satisfaction.
