ESD辅助联合化疗方案对早期食管黏膜病变患者近远期疗效的影响  

Effect of ESD combined with chemotherapy on short-term and long-term outcomes in patients with early esophageal mucosal lesions

作　　者：胡金飞[1] 黎萍[1] 胡望远[1] HU Jinfei;LI Ping;HU Wangyuan(Department of Radiotherapy,Jinhua Central Hospital in Zhejiang Province,Jinhua 321000,China)

机构地区：[1]浙江省金华市中心医院放疗科

出　　处：《中国现代医生》2019年第12期77-80,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2014ZDA027)

摘　　要：目的探讨内镜黏膜下剥离术(Endoscopic submucosal dissection,ESD)辅助联合化疗方案对早期食管黏膜病变患者近远期疗效的影响。方法回顾性分析2015年1月~2016年12月于我院治疗的60例早期食管黏膜病变患者的临床资料,其中30例患者治疗方案为紫杉醇和顺铂联合化疗(对照组),30例患者治疗方案为ESD联合紫杉醇和顺铂化疗(实验组)。观察比较两组患者近远期疗效、胃肠动力恢复时间、不良反应、复发及转移情况。结果实验组患者总有效率为93.33%,显著高于对照组的70.00%,差异有统计学意义(P<0.05)。随访结果显示:实验组16个月总体生存率和无进展生存率分别为83.33%和76.67%,均明显高于对照组的56.67%和43.33%(均P<0.05)。实验组患者的胃肠蠕动、肠鸣音、排便功能及肛门排气的恢复时间均明显比对照组患者短(均P<0.05)。两组出现白细胞减少、恶心呕吐及腹泻情况比较均无明显差异(均P>0.05);实验组复发率及转移率均明显低于对照组(均P<0.05)。实验组术中3例患者有出血症状,使用氩离子进行抗凝均得到缓解,术后2例患者发生吞咽困难情况。结论 ESD联合紫杉醇和顺铂化疗方案治疗早期食管黏膜病变患者可以明显提高近远期临床疗效,缩短患者胃肠动力恢复时间,降低其复发率及转移率,且无明显不良反应。Objective To investigate the effect of endoscopic submucosal dissection(ESD) combined with chemotherapy on the short-term and long-term effects of patients with early esophageal mucosal lesions. Methods The clinical data of 60 patients with early esophageal mucosal lesions treated in our hospital from January 2015 to December 2016 were retrospectively analyzed. 30 patients in the control group were treated with paclitaxel and cisplatin combined chemotherapy. 30 patients in the experimental group were treated with ESD combined with paclitaxel and cisplatin chemotherapy. The short-term and long-term efficacy, gastrointestinal motility recovery time, adverse reactions, recurrence and metastasis of the two groups were observed and compared. Results The total effective rate was 93.33% in the experimental group, which was significantly higher than 70.00% in the control group. The difference was statistically significant(P<0.05). The follow-up results showed that the 16-month overall survival rate and progression-free survival rate of the experimental group were 83.33% and 76.67%, respectively, which were significantly higher than 56.67% and 43.33% of the control group(both P<0.05). The gastrointestinal motility, bowel sounds, defecation function and recovery time of anal exhaust in the experimental group were significantly shorter than those in the control group(both P<0.05). There were no significant differences in leukopenia, nausea and vomiting and diarrhea between the two groups(P>0.05). The recurrence rate and metastasis rate of the experimental group were significantly lower than those of the control group(both P<0.05). In the experimental group, 3 patients had bleeding symptoms, and anticoagulation was relieved by using argon ions. Two patients had dysphagia after operation. Conclusion ESD combined with paclitaxel and cisplatin in the treatment of patients with early esophageal mucosal lesions can significantly improve the short-term and long-term clinical efficacy, shorten the gastrointestinal motility recovery

关 键 词：食管黏膜病变 内镜黏膜下剥离术 胃肠动力 疗效 

分 类 号：R735.1[医药卫生—肿瘤]