内镜黏膜下剥离术治疗早期未分化型胃癌的疗效及对凝血-纤溶系统的影响  

Efficacy of Endoscopic Submucosal Dissection in the Treatment of Early Undifferentiated Gastric Cancer and Its Effect on the Coagulation-fibrinolysis System

作　　者：陈步吉 游旭东 谷嘉华 CHEN Buji;YOU Xudong;GU Jiahua(Pingmei Shenma Medical Group General Hospital,Pingdingshan,467000)

机构地区：[1]平煤神马医疗集团总医院,467000

出　　处：《实用癌症杂志》2023年第5期803-806,共4页The Practical Journal of Cancer

摘　　要：目的探讨内镜黏膜下剥离术治疗早期未分化型胃癌的疗效及对凝血-纤溶系统的影响。方法选取79例早期未分化型胃癌患者作为研究对象,按照手术方法不同,将采用内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗的40例患者分为观察组(n=40),将采用胃癌根治术治疗的39例患者分为对照组(n=39),比较两组患者疗效、手术情况、并发症及凝血-纤溶相关指标情况。结果与对照组相比,观察组有效率较高,手术时间较短,出血量较少,肿瘤直径较大,并发症发生率较低(P<0.05);手术后,两组活化部分凝血酶时间(activated partial thromboplastin time,APTT)均低于手术前,纤维蛋白原(fibrinogen,FIB)均高于手术前,且观察组FIB低于对照组(P<0.05);手术后,两组D-二聚体(D-Dimer,D-D)及纤维蛋白降解产物(FDP)均高于手术前,且对照组高于观察组(P<0.05)。结论内镜黏膜下剥离术治疗早期未分化型胃癌有效率较高,手术时间较短且出血量较少,并发症发生率较低,同时术后FIB、D-D及FDP较低。Objective To investigate the effect of endoscopic submucosal dissection(ESD)on early undifferentiated gastric cancer and its influence on coagulation-coagulation system.Methods 79 patients with early undifferentiated gastric cancer were selected as the study object.According to the different surgical methods,40 patients treated with endoscopic submucosal dissection(ESD)were divided into the observation groCVup(n=40).39 patients treated with radical resection of gastric cancer were divided into the control group(n=39).The curative effect,surgical condition,complications and coagulation-fibrinolysis related indexes of the 2 groups were compared.Results Compared with the control group,the observation group had higher effective rate,shorter operation time,less blood loss,larger tumor diameter and lower incidence rate of complications(P<0.05).After operation,activated partial thrombin time(APTT)was lower than that before operation,fibrinogen(FIB)was higher than that before operation,and FIB in observation group was lower than that in control group(P<0.05).After operation,D-dimer(D-D)and fibrin degradation products(FDP)in both groups were higher than those before operation,and control group was higher than observation group(P<0.05).Conclusion Endoscopic submucosal dissection for early undifferentiated gastric cancer has higher effective rate,shorter operation time,less blood loss,lower incidence rate of complications,and lower postoperative FIB,D-D and FDP.

关 键 词：内镜黏膜下剥离术 胃癌 凝血-纤溶系统 

分 类 号：R735.2[医药卫生—肿瘤]