外科根治术与内镜黏膜下剥离术治疗早期胃癌患者的效果及对生活质量的影响  

Effectiveness of Surgical Radical Surgery and Endoscopic Submucosal Dissection in Treating Patients with Early Gastric Cancer and the Impact on Quality of Life

作　　者：祁金羽 施凉潘 QI Jinyu;SHI Liangpan(Department of Gastrointestinal Surgery,Quanzhou First Hospital,Quanzhou,Fujian Province,362000 China)

机构地区：[1]泉州市第一医院胃肠外科,福建泉州362000

出　　处：《中外医疗》2023年第19期82-85,90,共5页China & Foreign Medical Treatment

摘　　要：目的 探讨外科根治术与内镜黏膜下剥离术治疗早期胃癌患者的效果及对生活质量的影响。方法 方便选择2020年5月—2022年7月泉州市第一医院收治的早期胃癌患者94例为研究对象,根据手术方法不同将其分为外科根治组(外科根治术治疗)与内镜黏膜下剥离术(endoscopic submucosal dissection, ESD)组(内镜黏膜下剥离术治疗),每组47例。比较两组围术期指标、生活质量评分、胃肠动力激素和胃蛋白酶原水平、并发症发生率和复发率。结果 ESD组手术时间、术中出血量、住院时间、首次进食时间均优于外科根治组,差异有统计学意义(P<0.05)。ESD组术后6个月生活质量评分为(78.32±3.53)分高于外科根治组的(69.43±3.49)分,差异有统计学意义(t=12.278,P<0.05)。ESD组术后6个月血管活性肠肽、胃蛋白酶原Ⅱ低于外科根治组,胃动素、胃蛋白酶原Ⅰ高于外科根治组,差异有统计学意义(P<0.05)。ESD组并发症总发生率为4.26%低于外科根治组的17.02%,复发率为2.13%低于外科根治组的17.02%,差异有统计学意义(χ^(2)=4.029、4.424,P<0.05)。结论 相比外科根治术,应用内镜黏膜下剥离术治疗早期胃癌患者的效果显著,可改善患者围术期指标、胃肠动力激素和胃蛋白酶原水平,降低并发症发生率以及复发率,提升生活质量。Objective To investigate the effect of surgical radical surgery and endoscopic submucosal dissection in the treatment of early gastric cancer patients and the impact on quality of life.Methods Ninety-four patients with early gastric cancer admitted to Quanzhou First Hospital from May 2020 to July 2022 were conveniently selected as the study objects.According to different surgical methods,the patients were divided into the radical surgical group(radical surgical treatment)and the endoscopic submucosal dissection(ESD)group(endoscopic submucosal dissection),with 47 cases in each group.Perioperative indexes,quality of life score,gastrointestinal motivity hormone and pepsinogen levels,the incidence of complications and recurrence rate were compared between the two groups.Results Operation time,intraoperative blood loss,hospital stay and first feeding time in ESD group were better than those in radical surgery group,and the difference was statistically significant(P<0.05).The quality of life score of the ESD group at 6 months after operation was(78.32±3.53)points,which was higher than that of the radical surgery group(69.43±3.49)points,and the difference was statistically significant(t=12.278,P<0.05).Vasoactive intestinal peptide and pepsinogenⅡin ESD group were lower than those in radical surgery group,and motilin and pepsinogenⅠwere higher than those in radical surgery group 6 months after operation,the difference was statistically significant(P<0.05).The total complication rate of ESD group was 4.26%,which was lower than that of radical surgery group(17.02%),and the recurrence rate was 2.13%,which was lower than that of radical surgery group(17.02%),the difference was statistically significant(χ^(2)=4.029,4.424,P<0.05).Conclusion Compared with radical surgery,endoscopic submucosal dissection has a significant effect in the treatment of early gastric cancer patients,which can improve the perioperative indexes,gastrointestinal motivity hormone and pepsinogen levels of patients,reduce the incidence of complicati

关 键 词：外科根治术 内镜黏膜下剥离术 胃癌 胃肠动力激素 胃蛋白酶原 生活质量 

分 类 号：R73[医药卫生—肿瘤]