内镜黏膜下剥离术治疗未分化型早期胃癌的临床效果观察  

Clinical effect of endoscopic submucosal dissection in treatment of undifferentiated early gastric cancer

作　　者：程亭亭 杨磊[1] 高倩[1] CHENG Ting-ting;YANG Le;GAO Qian(Digestive Endoscopy Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化内镜中心,郑州450052

出　　处：《医药论坛杂志》2023年第22期30-33,37,共5页Journal of Medical Forum

摘　　要：目的研究未分化型早期胃癌(undifferentiated early gastric cancer,UD-EGC)采用内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗的临床效果。方法选取2019年1月—2021年12月郑州大学第一附属医院收治的UD-EGC患者76例,按治疗方法不同将予ESD治疗的38例作为试验组,将予手术治疗的38例作为对照组。对两组手术指标进行观察、手术效果进行判定、术后疼痛进行评估、肿瘤标志物水平进行检测、并发症发生率进行统计,并予以对比。结果试验组手术用时、术中失血量、术后第1次下床时间、术后首次排气时间与术后住院时间为(47.25±10.23)min、(20.34±2.18)mL、(1.57±0.46)d、(2.40±0.71)d及(9.14±2.37)d,手术各项指标均少于对照组(P<0.05);试验组完整切除率和治愈性切除率为97.37%和92.11%,低于对照组,但差异无统计学意义(P>0.05);试验组术后3d、1周与2周时VAS得分为(5.00±1.02)分、(3.66±0.39)分及(0.81±0.23)分,均低于对照组(P<0.05);和术前比,两组术后3个月肿瘤标志物及PG-Ⅱ、G-17水平均降低,PG-Ⅰ水平升高(P<0.05),但组间比较差异无统计学价值(P>0.05);试验组术后并发症总发生率5.26%,低于对照组的21.05%(P<0.05)。结论UD-EGC采用ESD治疗能减少出血、减轻疼痛及术后并发症,使康复时间缩短,值得推荐。Objective To study the clinical effect of endoscopic submucosal dissection(ESD)in the treatment of undifferentiated early gastric cancer(UD-EGC).Methods A total of 76 UD-EGC patients admitted to our hospital from January 2019 to December 2021 were selected.According to different treatment methods,38 cases receiving ESD treatment were selected as the experimental group,and 38 cases receiving surgical treatment were selected as the control group.The surgical indicators of the two groups were observed,the surgical effect was judged,the postoperative pain was evaluated,the level of tumor markers was detected,and the incidence of complications was statistically analyzed and compared.Results Operation time,intraoperative blood loss,first time of getting out of bed,first postoperative exhaust time and postoperative hospital stay in the experimental group were(47.25±10.23)min,(20.34±2.18)mL,(1.57±0.46)d,(2.40±0.71)d and(9.14±2.37)d.The indexes of operation were lower than those of control group(P<0.05).The complete resection rate and curative resection rate of the experimental group were 97.37%and 92.11%,which were slightly lower than the control group,but the difference was not statistically significant(P>0.05).VAS scores of the experimental group were(5.00±1.02)points,(3.66±0.39)points and(0.81±0.23)points at 3,1 and 2 weeks after surgery,which were lower than those of the control group(P<0.05).Compared with pre-operation,tumor markers,PG-Ⅱand G-17 levels were decreased,while PG-Ⅰlevels were increased in two groups 3 months after surgery(P<0.05),but there was no statistical value between groups(P>0.05).The total incidence of postoperative complications in the experimental group was 5.26%,lower than 21.05%in the control group(P<0.05).Conclusion ESD treatment of UD-EGC can reduce bleeding,relieve pain and postoperative complications,shorten the recovery time,and is worthy of recommendation.

关 键 词：并发症 未分化型早期胃癌 内镜黏膜下剥离术 

分 类 号：R735.2[医药卫生—肿瘤]