术前超声内镜联合FICE放大内镜检查在早期胃癌内镜治疗中的价值研究  

Study on value of preoperative endoscopic ultrasonography combined with FICE-magnifying endoscopy in the treatment of early gastric cancer

作　　者：张华伟 黄蓉 ZHANG Hua-wei;HUANG Rong(Department of Gastroenterology,Affiliated Hospital of Jinggangshan University,Ji'an 343000,China)

机构地区：[1]井冈山大学附属医院消化内科,343000 [2]吉安职业技术学院医护学院,343000

出　　处：《中国实用医药》2023年第15期95-98,共4页China Practical Medicine

基　　金：江西省卫健委科技项目基金资助(项目编号:202130710)。

摘　　要：目的探讨术前超声内镜联合智能电子分光技术系统(FICE)放大内镜检查在早期胃癌内镜治疗中的价值。方法回顾分析68例早期胃癌患者的临床资料,根据治疗前检查方法不同分为研究组和对照组,每组34例。研究组术前行超声内镜联合FICE放大内镜检查,对照组术前行仅普通胃镜检查,两组均行内镜下黏膜剥离术(ESD)治疗。比较两组患者手术结果。结果对照组ESD治疗患者中,术中转外科手术3例,ESD治愈性切除24例,非治愈性切除7例,其中5例追加外科手术,2例行二次ESD治疗。研究组ESD治疗患者中,术前超声内镜及放大内镜检查1例不符合内镜治疗指征,放弃ESD治疗转外科手术,余33例进行ESD,其中治愈性切除31例,非治愈性切除2例,其中1例追加外科手术,1例行二次ESD治疗。研究组患者的ESD治愈性切除率91.18%高于对照组的70.59%,两次治疗术(ESD+外科手术或ESD+ESD)占比5.88%低于对照组的29.41%,差异具有统计学意义(P<0.05)。结论超声内镜联合FICE放大内镜应用于早期胃癌诊治中可以有效提高患者的诊断准确率及ESD治愈性切除率,减少追加外科手术占比和两次治疗手术占比,使患者尽快康复,节约治疗费用,值得推广。Objective To discuss the value of preoperative endoscopic ultrasonography combined with Fuji intelligent chromoendoscopy(FICE)-magnifying endoscopy in the treatment of early gastric cancer.Methods The clinical data of 68 patients with early gastric cancer were retrospectively analyzed,and divided into research group and control group according to different pre-treatment examination methods,with 34 patients in each group.In the research group,preoperative endoscopic ultrasonography combined with FICE-magnifying endoscopy was performed,while in the control group,only routine gastroscopy was performed.Both groups were treated with endoscopic mucosal dissection(ESD),and the surgical results of the two groups were compared.Results Among the patients in the control group treated with ESD,3 cases were converted to surgery intraoperatively,24 cases were cured by ESD and 7 cases were not cured by ESD,among which 5 cases underwent additional surgery and 2 cases underwent secondary ESD treatment.Among the patients in the research group treated with ESD,1 case of preoperative endoscopic ultrasonography and amplification endoscopy did not meet the indications of endoscopic therapy and gave up ESD therapy for surgery,while the remaining 33 cases underwent ESD,including 31 cases of curative resection and 2 cases of non-curative resection,among which 1 case underwent additional surgery and 1 case underwent secondary ESD treatment.The curative resection rate of ESD was 91.18%in the research group,which was higher than that of 70.59%in the control group;the percentage of two treatment procedures(ESD+surgery or ESD+ESD)was 5.88%in the research group,which was lower than that of 29.41%of the control group;the differences were statistically significant(P<0.05).Conclusion Endoscopic ultrasonography combined with FICE-magnifying endoscopy in the treatment of early gastric cancer can effectively increase the curative resection rate of ESD,reduce the percentage of additional surgery and two treatment procedures,make patients recover as s

关 键 词：早期胃癌 超声内镜 智能电子分光技术系统放大内镜 内镜下黏膜剥离术 

分 类 号：R735.2[医药卫生—肿瘤]