内镜经黏膜下隧道肿瘤切除术对老年上消化道黏膜下肿瘤患者的影响  

Influence of Endoscopic Through Submucosal Tunnel Tumor Resection for Elderly Patients with Upper Gastrointestinal Submucosal Tumors

作　　者：彭如洁 曾庆新 邱锋 PENG Rujie;ZENG Qingxin;QIU Feng(Fujian Geriatric Hospital,Fuzhou 350000,China;不详)

机构地区：[1]福建省老年医院,福建福州350000

出　　处：《中外医学研究》2023年第35期5-9,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：福建省卫生计生面向农村和城市社区推广适宜技术项目(2018011)。

摘　　要：目的:探究内镜经黏膜下隧道肿瘤切除术对老年上消化道黏膜下肿瘤患者的影响。方法:选择2019年2月—2023年6月福建省老年医院收治的102例老年上消化道黏膜下肿瘤患者。根据随机数表法分为对照组和观察组,各51例。对照组采用内镜黏膜下剥离术治疗,观察组则采用内镜经黏膜下隧道肿瘤切除术治疗。比较两组的完全切除率、手术时间、术中出血量、住院时间、并发症发生率、术后疼痛反应程度[视觉模拟评分法(VAS)评分]、围手术期血流动力学指标[收缩压(SBP)、舒张压(DBP)及心率(HR)]及应激指标[血清皮质醇(Cor)、醛固酮(ALD)及去甲肾上腺素(NE)]。结果:两组完全切除率比较,差异无统计学意义(P>0.05),观察组手术时间、住院时间显著短于对照组,术中出血量显著少于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率显著低于对照组,差异有统计学意义(P<0.05)。术后2 h、6 h、12 h及24 h,观察组VAS评分显著低于对照组,差异有统计学意义(P<0.05)。术前,两组血流动力学指标比较,差异无统计学意义(P>0.05);术中10 min及术后即刻,观察组SBP、DBP、HR显著低于对照组,差异有统计学意义(P<0.05)。术前,两组应激指标比较,差异无统计学意义(P>0.05);术中10 min及术后即刻,观察组Cor、ALD及NE显著低于对照组,差异有统计学意义(P<0.05)。结论:内镜经黏膜下隧道肿瘤切除术对老年上消化道黏膜下肿瘤患者血流动力学及应激指标的影响相对更小,更有助于患者手术的顺利进行及术后的尽快康复。Objective:To explore the effect of endoscopic through submucosal tunnel tumor resection on elderly patients with upper gastrointestinal submucosal tumors.Method:A total of 102 elderly patients with upper gastrointestinal submucosal tumors treated in Fujian Geriatric Hospital from February 2019 to June 2023 were selected.According to random number table method,they were divided into control group and observation group,with 51 cases in each group.The control group was treated with endoscopic submucosal dissection,and the observation group was treated with endoscopic through submucosal tunnel tumor resection.Total resection rate,operation time,intraoperative blood loss,length of hospital stay,complication rate,postoperative pain response degree[visual analogue scale(VAS)score],perioperative hemodynamic indexes[systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)]and stress indexes[serum cortisol(Cor)and aldosterone(ALD)and norepinephrine(NE)]were compared between the two groups.Result:There was no significant difference in the total resection rate between the two groups(P>0.05).The operation time and hospital stay in the observation group were significantly shorter than those in the control group,and the amount of intraoperative blood loss was significantly less than that in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The VAS score of the observation group were significantly lower than those of the control group at 2 h,6 h,12 h and 24 h after operation,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in hemodynamic indexes between the two groups(P>0.05).At 10 min and immediately after operation,SBP,DBP and HR in the observation group were significantly lower than those in the control group,and the differences were statistically signi

关 键 词：内镜经黏膜下隧道肿瘤切除术 老年患者 上消化道黏膜下肿瘤 血流动力学 应激指标 

分 类 号：R735[医药卫生—肿瘤]