超声内镜结合内镜下黏膜剥离对可疑直肠类癌患者炎症应激反应及诊疗效果的影响  

Effect of endoscopic ultrasonography combined with endoscopic mucosal dissection on inflammatory stress re-sponse and diagnosis and treatment of suspected rectal carcinoid patients

作　　者：曹洋辉 贾万奇[1] 马瑾 Cao Yanghui;Jia Wanqi;Ma Jin(Digestive Endoscopy Center of the Second People′s Hospital of Nanyang City,Henan 473000,China;不详)

机构地区：[1]河南省南阳市第二人民医院消化内镜诊疗中心,473000 [2]河南省南阳市宛城区中医院内二科

出　　处：《实用医技杂志》2021年第12期1413-1416,共4页Journal of Practical Medical Techniques

摘　　要：目的探讨超声内镜检查结合内镜下黏膜剥离术(ESD)对可疑直肠类癌患者应激反应、炎症因子、镜下治疗效果及诊断结果的影响。方法挑选2017年12月至2020年12月于本院收治的可疑直肠类癌患者30例,分为2组,每组15例。对照组均未行超声内镜检查,凭医生经验考虑类癌,后行内镜下黏膜切除术(EMR)或ESD;试验组均已行超声内镜检查考虑类癌,后行ESD;2组镜下治疗不成功者转为外科手术。比较2组患者应激反应指标、炎症因子水平、镜下治疗效果及诊断结果准确率。结果术后1 d 2组患者游离三碘甲状腺原氨酸(FT3)比术前降低(P<0.05),且对照组FT3低于试验组(P<0.05)。术后1 d、3 d 2组患者皮质醇均比术前升高(P<0.05)且对照组皮质醇高于试验组(P<0.05)。2组患者FT3、皮质醇分别于术后3 d、5 d恢复至术前水平(P>0.05)。术后1 d、3 d、5 d,2组患者炎症因子水平均比术前升高(P<0.05)且对照组炎症因子高于试验组(P<0.05)。对照组患者镜下治疗成功率低于试验组(P<0.05)。对照组患者术前术后诊断准确率低于试验组(P<0.05)。结论超声内镜检查结合ESD能明显减轻可疑直肠类癌患者的应激反应,减少炎症因子的释放,提高镜下治疗的成功率及诊断的准确率。Objective To explore the effect of endoscopic ultrasonography combined with endoscopic mucosal dissection on stress response,inflammatory factors,therapeutic effect,and the diagnosis of suspected rectal carcinoid patients.Methods Thirty patients with suspected rectal carcinoid were selected from December 2017 to December 2020,and divided into two groups of 15 subjects each.No endoscopic ultrasonography was performed in the control group,and carcinoid was considered based on doctors′experience,followed by endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESD).In the experimental group,carcinoid was considered based on endoscopic ultrasonography,followed by ESD.Furthermore,surgery was performed in the two groups if the treatment was unsuccessful.The stress reaction index,the level of inflammatory factors,the therapeutic effect under the microscope,and the accuracy of diagnosis were compared in the two groups.Results The free triiodothyronine(FT3)in the two groups was lower than that in the control and experimental groups(P<0.05).However,the cortisol level in the control group was higher when compared with the experimental group(P<0.05).The levels of FT3 and cortisol in the two groups were restored to preoperative levels on the 3rd and 5th days after the operation(P>0.05).On the 1st,3rd,and 5th days after the operation,the level of inflammatory factors in the two groups was higher than that before the operation(P<0.05),and that in the control group was higher than that in the experimental group(P<0.05).The success rate of the control group was lower than that of the experimental group(P<0.05).The accuracy of preoperative and postoperative diagnosis in the control group was lower compared with the experimental group(P<0.05).Conclusion Endoscopic ultrasonography combined with endoscopic mucosal dissection can significantly reduce the stress response in patients with suspected rectal carcinoid,inhibit the release of inflammatory factors,and improve the success rate of endoscopic treatment and the a

关 键 词：腔内超声检查 直肠 类癌 内镜下黏膜剥离 炎症应激反应 诊疗效果 

分 类 号：R735.37[医药卫生—肿瘤]