内镜下黏膜剥离术治疗早期结直肠癌的疗效及对患者远期预后的影响  

Efficacy of endoscopic mucosal dissection in the treatment of early colorectal cancer and its influence on the long-term prognosis of patients

作　　者：秦蕾[1] 李广鹏[1] 张兰芳[1] 秦咏梅[1] QIN Lei;LI Guangpeng;ZHANG Lanfang;QIN Yongmei(Department of Gastrology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,He’nan,China)

机构地区：[1]新乡医学院第一附属医院消化内科,河南新乡4531000

出　　处：《癌症进展》2022年第9期966-968,971,共4页Oncology Progress

摘　　要：目的探讨内镜下黏膜剥离术治疗早期结直肠癌的疗效及对患者远期预后的影响。方法依据手术方式的不同将113例早期结直肠癌患者分为对照组(n=55)和观察组(n=58),对照组患者给予腹腔镜结直肠癌根治术治疗,观察组患者给予内镜下黏膜剥离术治疗。比较两组患者的手术相关指标、炎性因子[肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平、并发症发生情况和术后3年预后情况。结果观察组患者术中出血量明显少于对照组,手术时间、首次排气时间、首次排便时间、术后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3天,两组患者TNF-α、hs-CRP、IL-6水平均高于本组术前,且观察组患者TNF-α、hs-CRP、IL-6水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率为5.17%,与对照组患者的10.91%无明显差异(P﹥0.05)。随访3年,观察组患者的复发率、生存率分别为1.72%、91.38%,与对照组患者的5.45%、89.09%均无明显差异(P﹥0.05)。结论内镜下黏膜剥离术可改善早期结直肠癌患者的手术相关指标,减轻手术应激反应,促进患者的术后恢复,具有良好的疗效和安全性。Objective To investigate the efficacy of endoscopic mucosal dissection in the treatment of early colorec-tal cancer and its influence on the long-term prognosis of patients.Method According to different surgical methods,113 patients with early-stage colorectal cancer were divided into control group(n=55)and observation group(n=58).The pa-tients in the control group were treated with laparoscopic radical resection of colorectal cancer,and the patients in the ob-servation group were treated with endoscopic mucosal dissection.The operation-related indicators,inflammatory factors[tumor necrosis factor-α(TNF-α),high-sensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)]levels,complications and 3-year postoperative prognosis were compared between the two groups.Result The intraoperative blood loss in the observation group was significantly less than that in the control group,and the operation time,time to first exhaust,time to first defecation,and postoperative hospital stay were significantly shorter than those in the control group,the differenc-es were statistically significant(P<0.01).Three days after the operation,the levels of TNF-α,hs-CRP,and IL-6 in the two groups were higher than those before the operation,and the levels of TNF-α,hs-CRP,and IL-6 in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 5.17%,which was not significantly different from 10.91%in the control group(P>0.05).During the 3-year follow-up,the recurrence rate and survival rate of the observation group were 1.72%and 91.38%,respectively,which had no significant differences from 5.45%and 89.09%of the control group(P>0.05).Conclusion Endoscopic mucosal dissection can improve the operation-related indicators of patients with early colorectal cancer,reduce the stress response of surgery,and promote the postoperative recovery of patients,with good efficacy and safety.

关 键 词：结直肠癌 内镜下黏膜剥离术 远期预后 

分 类 号：R735.3[医药卫生—肿瘤]