内镜下黏膜切除术联合氩等离子体凝固术治疗老年早期食管癌及癌前病变患者的临床疗效  

Clinical efficacy of endoscopic mucosal resection combined with argon plasma coagulation in the treatment of elderly patients with early esophageal cancer and precancerous lesions

作　　者：邵君 唐燕锋 SHAO Jun;TANG Yanfeng(Department of Internal Medicine,Zhoupu Hospital,Pudong New Area,Shanghai 200123,China;Department of Gastroenterology,Ruijin Rehabilitation Hospital,Huangpu District,Shanghai 200123,China)

机构地区：[1]上海市浦东新区周浦医院内科,上海200123 [2]黄浦区瑞金康复医院消化内科,上海2001230

出　　处：《癌症进展》2021年第6期592-595,共4页Oncology Progress

摘　　要：目的探讨内镜下黏膜切除术(EMR)联合氩等离子体凝固术(APC)治疗老年早期食管癌及癌前病变患者的临床疗效。方法根据手术方法的不同将80例老年早期食管癌及癌前病变患者分为观察组(n=41)和对照组(n=39)。观察组患者采用EMR联合APC治疗,对照组患者采用EMR治疗。比较两组患者的围手术期指标、术前和术后的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分以及术后并发症发生情况。术后6个月进行随访,比较两组患者的病理诊断结果。结果观察组患者的剥离面积和单位时间切除率均明显大于对照组,手术时间和住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。术后观察组患者的SAS和SDS评分均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的术后并发症总发生率为7.32%,低于对照组的23.08%,差异有统计学意义(P﹤0.05)。术后6个月,观察组患者的病理结果优于对照组,差异有统计学意义(P﹤0.05)。结论EMR联合APC应用于老年早期食管癌及癌前病变患者能够缩短患者的住院时间,改善患者的负性情绪,降低术后并发症发生率,促进患者术后恢复。Objective To investigate the clinical efficacy of endoscopic mucosal resection(EMR)combined with argon plasma coagulation(APC)in the treatment of elderly patients with early esophageal cancer and precancerous lesions.Method According to different surgical methods,80 elderly patients with early esophageal cancer or precancerous lesions were divided into observation group(n=41)and control group(n=39).Patients in the observation group were treated with EMR combined with APC,while patients in the control group were treated with EMR.The perioperative indexes,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores before and after operation and the incidence of postoperative complications were compared between the two groups.Follow-up was performed 6 months after operation,and the pathological diagnosis results of the two groups were compared.Result The dissection area and resection rate in the observation group were significantly larger than those in the control group,and the operation time and hospital stay were significantly shorter than those in the control group(P<0.01).The scores of SAS and SDS in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was 7.32%,which was lower than that of 23.08%in the control group(P<0.05).Six months after operation,the pathology results in the observation group was better than that in the control group(P<0.05).Conclusion EMR combined with APC in elderly patients with early esophageal cancer and precancerous lesions can shorten the hospitalization time,improve the negative mood of patients,reduce the incidence of postoperative complications and promote the recovery of patients after operation.

关 键 词：早期食管癌 癌前病变 内镜下黏膜切除术 氩等离子体凝固术 

分 类 号：R735.1[医药卫生—肿瘤]