内镜黏膜下剥离术与切除术治疗消化道早癌及癌前病变的有效性及安全性  

Effectiveness and safety of ESD and EMR in the treatment of early gastrointestinal cancer and precancerous lesions

作　　者：吴晨[1] WU Chen(He′nan Cancer Hospital,Zhengzhou,He′nan 450000,China)

机构地区：[1]河南省肿瘤医院,郑州450000

出　　处：《现代医药卫生》2019年第3期367-369,共3页Journal of Modern Medicine & Health

摘　　要：目的比较内镜黏膜下剥离术(ESD)与内镜黏膜切除术(EMR)治疗消化道早癌及癌前病变的有效性及安全性,探讨ESD在消化道早癌及癌前病变中的治疗价值。方法以2014年3月至2016年10月该院收治的225例消化道早癌及癌前病变患者为研究对象,按照不同手术方式分为ESD组(n=115)与EMR组(n=110)。比较2组术后疼痛程度、术后并发症发生率、术后完整切除率,以及随访3、6、12个月的复发率和QLQ-C30生活质量评分。结果ESD组患者术后疼痛程度显著低于EMR组,差异有统计学意义(Z=6.683,P=0.004);ESD组术后并发症总发生率显著低于EMR组,术后完整切除率显著高于EMR组,差异均有统计学意义(χ2=10.352、7.528,P=0.000、0.005);在术后3、6、12个月,2组复发率比较,差异均无统计学意义(P>0.05),但ESD组的QLQ-C30生活质量评分均显著高于EMR组,差异均有统计学意义(t=6.634、4.128、5.776,P=0.000、0.000、0.000)。结论 ESD治疗消化道早癌及癌前病变具有较好的有效性及安全性。Objective To compare the effectiveness and safety of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)in the treatment of early gastrointestinal cancer and precancerous lesions,and to discuss the therapeutic value of ESD in the treatment of early gastrointestinal cancer and precancerous lesions.Methods A total of 225 patients with early gastrointestinal cancer and precancerous lesionswas were the study objects in the hospital from March 2014 to October 2016,which were divided into ESD group(n=115)and EMR group(n=110)according to different operation ways.The surgical time,intraoperative blood loss,hospitalization time,wound healing time,postoperative pain degree,postoperative complication rate,postoperative complete resection rate and recurrence rate,QLQ-C30 life quality scores followed-up 3,6,12 months were compared between two groups.Results The postoperative pain degree of ESD group was significantly lower than that of EMR group,the difference was statistically significan(Z=6.683,P=0.004).The postoperative complication rate of ESD group was significantly lower than that of EMR group,the postoperative complete resection rate of ESD group was significantly higher than that of EMR group,the differences were statistically significan(χ^2=10.352,7.528,P=0.000,0.005).Following-up 3,6,12 months,there were no statistical significance of recurrence rate between two groups(P >0.05),the QLQ-C30 life quality scores of ESD group was significantly higher than that of EMR group,the differences were statistically significan(t=6.634,4.128,5.776,P=0.000,0.000,0.000).Conclusion ESD has better effectiveness and safety in the treatment of early gastrointestinal cancer and precancerous lesions.

关 键 词：黏膜 消化系统肿瘤 癌前状态 消化道早癌 癌前病变 内镜黏膜下剥离术 内镜黏膜切除术 

分 类 号：R735[医药卫生—肿瘤]