消化道早期癌的内镜黏膜下剥离和外科手术治疗疗效比较  

Comparison on the therapeutic efficacies of endoscopic submucosal dissection and surgical operationtreatment of early gastrointestinal cancers

作　　者：朱芳来[1] 凌安生 

机构地区：[1]安庆市第一人民医院消化内科,安徽省安庆市246003

出　　处：《中国医师杂志》2013年第4期445-448,共4页Journal of Chinese Physician

基　　金：2009年安徽省卫生厅医学科研课题项目（09C144）

摘　　要：目的观察比较消化道早期癌的内镜黏膜下剥离和外科手术治疗疗效。方法60例消化道早期癌患者分成两组，33例给予内镜黏膜下剥离（endoscopic submucosal dissection，ESD）治疗（ESD组），27例给予外科手术治疗（外科组）。治疗过程中观察两种方法的治疗成功率、生存时间、复发及转移情况、营养状况、不良反应及并发症的发生率、住院时间及治疗费用。结果ESD组和外科组的治疗成功率、生存时间、复发及转移情况比较差异无统计学意义（P〉0．05）；ESD组营养状况达正常值率90．9％（30／33），外科组营养状况达正常值率66．7％（18／27）；ESD组不良反应及并发症发生率为9．09％（3／33），外科组不良反应及并发症发生率为59．2％（16／27）。两组营养状况达正常值率、不良反应及并发症发生率差异有统计学意义（P〈0．05，P〈0．01）。ESD组住院时间（14．81±3．27）d，治疗费用（10562．01±3060．08）元；外科组住院时间（19．22±6．91）d，治疗费用（16587．87±5664．50）元。外科组住院时间较ESD组长，治疗费用较ESD组贵。结论消化道早期癌ESD治疗，与外科手术的疗效相当，术后不良反应较外科手术发生率低，住院时间短，治疗费用相对较低，特别是能保留患者消化道的完整性，生活质量显著提高。Objective To compare the therapeutic efficacies of endoscopic submucosal dissection and surgical operation treatment of early gastrointestinal cancers. Methods Sixty patients with early gastroin- testinal cancer were divided into the endoscopic submucosal dissection （ESD） treatment group （ n = 33 patients） and surgical operation treatment group （ n = 27 patients ）. During the treatment, success rate, survival time, recurrence and metastasis, nutritional status, adverse reaction and complication rate, hospital stay, and cost of treatment were observed for two groups. Results No statistical significances in success rate, survival time, recurrence and metastasis were found between two groups （ P 〉 0.05 ）. The rate of normal nutritional status value was 90. 9% （30/33） in group ESD and 66. 7% （18/27） in the surgical group with a statistically significant difference between two groups （ P 〈 0. 05）. The rate of adverse reac- tion and complication was 9. 09% （3/33） in group ESD and 59. 2% （16/27） in the surgical group with a statistically significant difference between two groups （ P 〈 0.05, P 〈 0. 01 ）. The average length of stay （ 14. 81 ± 3.27） days and the average hospitalization expenses （ 10562. 01 ± 3060.08 ） Yuan were occurred in the group ESD. The average length of hospital stay （ 19. 22 ± 6. 91 ） days and the average hospitalization expenses （16587. 87 ±5664. 50）Yuan were occurred in the surgical group. The average length of hospital stay in Surgical group was longer 4,41 days than group ESD. The average hospitalization expense in surgical group was 6025.86 yuan more than the ESD group. Conclusions The curative effects of ESD treatment was similar to surgical operation, and there was a lower postoperative adverse reaction rate, a shorter time of hospitalization, a relatively low cost of treatment for ESD treatment compared to the surgical operation. Mo-reover, ESD treatment can especially keep the gastrointestinal integrity for patients, and th

关 键 词：内窥镜检查 黏膜 外科学 消化系统肿瘤 外科学 

分 类 号：R735[医药卫生—肿瘤]