内镜下黏膜切除术及其随访对胃黏膜不典型增生患者的意义  

Clinical significance of endoscopic mucosal resection and follow-up for patients with gastric mucosal atypical hyperplasia

作　　者：陈立敏[1] 祖庆余 王艳玲[1] 龚莹莹[1] 赵静[1] 张玉波[1] 

机构地区：[1]河北省涿州市医院消化内科,河北涿州072750

出　　处：《临床和实验医学杂志》2015年第14期1185-1187,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨胃黏膜不典型增生患者内镜下黏膜切除术及内镜随访的临床效果。方法选取2006年1月至2014年1月因胃黏膜不典型增生而定期进行内镜随访的患者150例为随访组,选取因重度胃黏膜不典型增生而行内镜下黏膜切除术并定期进行内镜随访的100例患者为治疗组。对比分析两组患者发生癌变和疾病逆转情况。结果治疗组患者的平均随访时间(3.9±0.6年)短于随访组(4.5±0.8年),差异有统计学意义(P<0.05)。治疗组患者的平均每人复查内镜次数(4.3±0.7次)低于随访组(5.1±0.5次),差异有统计学意义(P<0.05)。治疗组患者的逆转率(47.00%)低于随访组(63.33%),癌变率(3.00%)低于随访组(12.00%),差异均有统计学意义(P<0.05)。随着胃黏膜不典型病变程度的加重,逆转率逐渐降低,癌变率逐渐升高,差异具有统计学意义(P<0.05)。结论随访可以使胃黏膜不典型增生患者早期发现胃癌,内镜下黏膜切除术则可以减少这类患者的癌变。Objective To investigate the clinical significance of endoscopic mucosal resection and follow - up for gastric mucosal atypical hyperplasia （GMAH） patients. Methods One hundred fifty regular endoscopic follow - up cases of GMAH diagnosed in our hospital from January 2006 to January 2014 were selected as follow -up group, 100 severe GMAH cases with endoscopic mucosal resection and regular endoscopic fol- low - up as the treatment group. Canceration rate and disease reversal rate were compared between two groups. Results The mean follow - up time in the treatment group was shorter than the follow - up group （3.9 ± 0.6 vs. 4.5 ± 0.8 years, P 〈 0.05 ） , and the mean times of endoscope examination in the treatment group was less than the follow-up group （4.3 ＋ 0.7 vs. 5.1 ± 0. 5, P 〈 0. 05 ）. The reversal rate in the treatment group was lower than the follow - up group, the difference was statistically significant （47.00% vs. 63.33 %, P 〈 0.05 ）. The caneeration rate in the treatment group was lower than the follow -up group, the difference was statistically significant （3.00% vs. 12.00%, P 〈 0.05 ）. With the aggravation of gastric mucosal atypical lesions, the reversal rate gradually decreased and canceration rate gradually increased, the differences were statistically significant （ P 〈 0.05 ）. Conclusion Early detection of gastric canceration can be reached by regular endoscopic follow - up for GMAI-I patients, endoscopic mucosal resection can reduce eanceration rate for these patients.

关 键 词：胃黏膜 不典型增生 内镜 黏膜切除术 随访 

分 类 号：R573[医药卫生—消化系统]