内镜黏膜下剥离术治疗大肠侧向发育型肿瘤的临床效果  

Clinical effect of endoscopic submucosal dissection in the treatment of laterally spreading tumor

作　　者：曾德辉[1] 汪福群[1] 王胜炳[1] ZENG De-hui;WANG Fu-qun;WANG Sheng-bing(Department of Gastroenterology,People′s Hospital of Meizhou City in Guangdong Province,Meizhou,514031,China)

机构地区：[1]广东省梅州市人民医院消化内科,广东梅州514031

出　　处：《中国当代医药》2020年第5期105-107,共3页China Modern Medicine

摘　　要：目的探讨内镜黏膜下剥离术(ESD)治疗大肠侧向发育型肿瘤的临床效果。方法选取2015年1月~2018年5月广东省梅州市人民医院收治的90例大肠侧向发育型肿瘤患者作为研究对象,根据随机数字表法分为对照组(45例)和观察组(45例)。对照组患者采用内镜下黏膜切除术(EMR)治疗,观察组患者采用ESD治疗。随访12个月,比较两组患者的手术指标、并发症发生率及复发率。结果两组患者的术中出血量比较,差异无统计学意义(P>0.05);观察组患者的整块切除率、完整切除率均高于对照组,差异有统计学意义(P<0.05);观察组患者术后迟发性出血、肠穿孔、切口感染的发生率均低于对照组,差异有统计学意义(P<0.05);两组患者术后6个月的复发率比较,差异无统计学意义(P>0.05);观察组患者术后12个月的复发率低于对照组,差异有统计学意义(P<0.05)。结论ESD治疗大肠侧向发育型肿瘤的手术创伤较小,病灶整块切除率、完整切除率优于EMR,且复发率较低,未增加并发症发生率,值得推广应用。Objective To investigate the clinical effect of endoscopic submucosal dissection(ESD)in the treatment of lateral large intestine tumors.Methods Ninety patients with laterally spreading tumor treated in Meizhou People′s Hospital of Guangdong Province from January 2015 to May 2018 were selected as the subjects,and divided into control group(45 cases)and observation group(45 cases)by random number table method.The control group was treated with endoscopic mucosal resection(EMR),and the observation group was treated with ESD.Both groups were followed up for 12 months.The surgical indexes,incidence of complications and recurrence rate were compared between the two groups.Results There was no significant difference in intraoperative blood loss between the two groups(P>0.05).The whole resection rate and complete resection rate in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of bleeding,intestinal perforation and wound infection was lower than that of the control group,the difference was statistically significant(P<0.05).There was no significant difference in the recurrence rate at 6 months after operation(P>0.05).The recurrence rate in the observation group was lower than that in the control group at 12 months after operation,the difference was statistically significant(P<0.05).Conclusion ESD for the treatment of laterally spreading tumor has less trauma,and the rate of complete resection and complete resection is better than EMR,and the recurrence rate is low,and the incidence of complications is not increased.It is worth promoting.

关 键 词：内镜黏膜下剥离术 大肠侧向发育型肿瘤 内镜下黏膜切除术 临床效果 

分 类 号：R735.34[医药卫生—肿瘤]