内镜黏膜下剥离术治疗上消化道黏膜下病变的疗效研究  

Curative Effect of ESD in the Treatment of Submucosal Lesions of Upper Gastrointestinal Tract

作　　者：李勇[1] 王翻身 王昕[1] 张渊[1] 

机构地区：[1]包头市蒙医中医医院普外科,内蒙古包头014040

出　　处：《中外医疗》2016年第10期38-40,共3页China & Foreign Medical Treatment

摘　　要：目的探究对上消化道黏膜下病变病例使用内镜黏膜下剥离术治疗的疗效。方法随机抽取在2013年1月—2015年1月于该科室治疗胆囊结石的病例64例,将其分为治疗组和对照组两组,每组32例,两组分别使用内镜黏膜下剥离术和内镜黏膜切除术。对治疗后的效果及相关指标进行测评。结果治疗组出血(3.1%)、穿孔并发症发生(0%)及复发率(0.0%)明显小于对照组(12.4%、6.2%、6.2%)(P=0.014,0.011,0.011<0.05),病变直径>3 cm与≤3 cm两种病变部位切缘阳性率(20.0%、0.0%)均明显小于对照组(37.5%、12.5%)(P=0.006,0.000<0.05),但手术时间(67.8±14.3)min明显长于对照组(31.2±12.2)min(P=0.000<0.05),均为有显著性差异。结论内镜黏膜下剥离术能有效切除上消化道黏膜下病变,减少复发率和并发症,效果明显优于内镜黏膜下切除术,值得推广。Objective To study the curative effect of ESD（endoscopic submucosal dissection） in the treatment of submucosal lesions of upper gastrointestinal tract. Methods 64 patients with gallstone treated from January 2011 to January 2015 in our department were randomly selected. The subjects were divided into treatment group and control group, 32 cases each group. Two groups respectively adopted ESD and EMR（endoscopic mucosal resection）. After treatment, the relative index was evaluated. Results The bleeding situation（3.1%）、incidence rate of complications（0.0%） and recurrence rate（0.0%）for treatment group was signficantly lower than that of control group（12.4%、6.2%、6.2%）（P=0.014,0.011,0.011〈0.05）;the positive rate of incisal edge for treatment group（20.0% 、0.0%）was lower than that of control group（37.5% 、12.5%）（P=0.006,0.000〈0.05）; the operation time of treatment group（67.8±14.3）was longer than that of control group（31.2±12.2）（P=0.000〈0.05）.Conclusion ESD has an obvious effect in the treatment of submucosal lesions of upper gastrointestinal tract and reduces the recurrence rate and incidence rate of complications. Its clinical effect is better than that of EMR. It is worthy of promotion.

关 键 词：黏膜下病变 内镜 上消化道 疗效 黏膜下剥离术 

分 类 号：R57[医药卫生—消化系统]