内镜黏膜下剥离术治疗胃癌的临床疗效及对患者预后的影响  

Clinical efficacy of endoscopic submucosal dissection in the treatment of gastric cancer and its influence on the prognosis of patients

作　　者：张恩宇[1] 李泉[1] 吴璇[1] 杨齐[1] ZHANG Enyu;LI Quan;WU Xuan;YANG Qi(Department of General Surgery,Fuxing Hospital,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属复兴医院普外科,北京1000100

出　　处：《癌症进展》2022年第12期1235-1238,共4页Oncology Progress

摘　　要：目的探讨内镜黏膜下剥离术治疗胃癌的临床疗效及对患者预后的影响。方法依据手术方法的不同将98例胃癌患者分为对照组和观察组,每组49例,对照组患者给予内镜黏膜切除术,观察组患者给予内镜黏膜下剥离术。比较两组患者的手术相关指标、胃肠功能指标(D-乳酸、二胺氧化酶)、肿瘤标志物水平[livin、表皮生长因子(EGF)]、病变整块切除率、并发症发生情况以及随访2年生存复发情况。结果观察组患者手术时间、胃肠功能恢复时间、住院时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。术后,两组患者D-乳酸、二胺氧化酶、livin、EGF水平均明显低于本组术前,且观察组患者D-乳酸、二胺氧化酶、livin、EGF水平均明显低于对照组,差异均有统计学意义(P﹤0.01)。观察组患者的病变整块切除率为95.92%,明显高于对照组的77.55%(P﹤0.01)。观察组患者的并发症总发生率为6.12%,低于对照组患者的22.45%(P﹤0.05)。术后2年,观察组患者总生存率高于对照组,复发率低于对照组,差异均有统计学意义(P﹤0.05)。结论内镜黏膜下剥离术能够明显促进胃癌患者的术后恢复,改善预后,且安全性较高。Objective To investigate the clinical efficacy of endoscopic submucosal dissection in the treatment of gastric cancer and their impact on the prognosis of patients.Method According to different surgical methods,98 patients with gastric cancer were divided into control group and observation group,with 49 cases in each group.The patients in the control group were given endoscopic mucosal resection,and the patients in the observation group were given endoscopic submucosal dissection.The operation-related indexes,gastrointestinal function indexes(D-lactate,diamine oxidase),tumor marker levels[livin,epidermal growth factor(EGF)],en bloc resection rate,complications,and 2-year fol-low-up survival and recurrence were compared between the two groups.Result The operation time,gastrointestinal function recovery time,and hospitalization time of the observation group were significantly shorter than those of the control group,and the intraoperative blood loss was significantly less than that of the control group,and the differences were statistically significant(P<0.01).After operation,the levels of D-lactate,diamine oxidase,livin,and EGF in the two groups were significantly lower than those before the operation,and the levels of D-lactate,diamine oxidase,livin,and EGF in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.01).The en bloc resection rate was 95.92%in the observation group,which was significantly higher than 77.55%the control group(P<0.01).The total incidence of complications in the observation group was 6.12%,which was lower than 22.45%in the control group(P<0.05).Two years after operation,the overall survival rate of the observation group was higher than that of the control group,and the recurrence rate was lower than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Endoscopic submucosal dissection can significantly promote the postoperative recovery of gastric cancer patients,impro

关 键 词：胃癌 内镜黏膜下剥离术 安全性 短期预后 

分 类 号：R735.2[医药卫生—肿瘤]