Management status of pulmonary nodules in the central hospital of Putuo district, Shanghai / 中华健康管理学杂志

ABSTRACT

Objective To investigate the status of pulmonary nodules management in central hospital of Shanghai Putuo District. Methods In 2016 and 2017, patients with solitary pulmonary nodules found by low-dose spiral CT were selected during the initial physical examination in Putuo District Central Hospital of Shanghai. The pulmonary nodules were 4-8 mm in diameter and aged 30-85 years. The patients with pulmonary nodules in 2016 were the control group, and only routine management was carried out. The patients with pulmonary nodules in 2017 were in the health management group. Health records were established, health education was carried out, and follow-up was carried out. After one year of comparative intervention, the effect of health management of pulmonary nodules was evaluated in the two groups by their awareness of pulmonary nodules, negative psychological status, follow-up and the number of pulmonary nodules diagnosed as lung cancer by dynamic changes in pulmonary nodules during one year of follow-up. Results The detection rates of the pulmonary nodules were 11.2% (4 361/38 793) and 12.1% (5 056/41 482) in the first physical examination population in 2016 and 2017, respectively, with no significant difference (χ2=29.641, P=0.128). The control group included 4 361 cases and the health management group included 5 056 cases. The follow-up rate of health management group was 78.0% (2 878 cases) higher than that of the control group (66.0%, 3 944 cases). The difference was statistically significant (χ2 =4.174, P=0.016). In the health management group, 4 651 patients (95.4%) had comprehensive knowledge of pulmonary nodules, higher than 1 820 patients (44.6%) in the control group (χ2=10.363, P=0.078). There were 1 213 (24.9%) patients with negative psychology such as panic and anxiety in the health management group, which was lower than 3 303 (81.0%) patients in the control group (χ2=6.414, P=0.102). During the follow-up period of the following year, 37 cases (0.7%) in the health management group were diagnosed as early lung cancer due to the dynamic changes of small nodules, and 19 cases (0.4%) in the control group. The difference was statistically significant (χ2=4.093, P<0.05). Conclusion Health management of patients with pulmonary nodules can improve their awareness of pulmonary nodules , reduce their negative psychology and increase the detection rate of early lung cancer. Health management of pulmonary nodules is valuable for early detection of lung cancer.