改良牵引辅助ESD对早期胃癌的治疗效果及并发症观察  

Observation of the therapeutic Effect and Complications of modified Traction assisted ESD on early gastric Cancer

作　　者：王玉玉 常廷民[1] WANG Yuyu;CHANG Tingmin(Endoscopy Department,Xinxiang Medical University First Affiliated Hospital,Xinxiang Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院内镜科,河南新乡453100

出　　处：《临床研究》2024年第6期26-29,共4页Clinical Research

摘　　要：目的探究改良牵引辅助内镜黏膜下剥离术(ESD)对早期胃癌的治疗效果,并观察并发症。方法选取新乡医学院第一附属医院2017年1月至2022年6月收治的60例胃癌早期患者为研究对象,按随机数表法分为对照组和观察组,每组各30例。对照组实行传统ESD治疗,观察组实行改良牵引辅助ESD治疗。比较两组患者手术平均时间、术中出血量、住院时间、病灶切除情况、病灶开始标记至完整剥离时间、黏膜暴露至完整剥离时间、血清炎症因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-12(IL-12)]含量、血清应激激素[肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)]含量,观察术后并发症情况。结果观察组手术平均时间、术中出血量、住院时间均少于对照组,差异有统计学意义(P<0.05)。两组共切除病灶60处,观察组病灶完整切除率与对照组比较差异无统计学意义(P>0.05)。观察组病灶开始标记至完整剥离时间及黏膜暴露至完整剥离时间均短于对照组,差异均有统计学意义(P<0.05)。术后1 d,观察组IL-6、IL-8、IL-12水平及E、NE、Cor水平均低于对照组,差异均有统计学意义(P<0.05)。60例患者中,3例出现术中出血,均在镜下止血成功,在ESD操作过程中均未出现难以控制的大出血情况;4例出现术中穿孔,均为3~5 mm的小穿孔,在术中予以金属夹夹闭,在术后进行治疗后痊愈;4例患者在术后出现腹痛、腹胀;1例出现感染。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论改良牵引辅助ESD治疗早期胃癌可以缩短手术时间,减少术中出血量,提高病灶剥离效果,安全性高。Objective To explore the therapeutic effect of modified traction assisted endoscopic submucosal dissection(ESD)on early gastric cancer and observe its complications.Methods A total of 60 patients with early gastric cancer admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2017 to June 2022 were selected as the study subjects.They were divided into control group and observation group,with 30 cases in each group,using a random number table method.The control group received traditional ESD treatment,while the observation group received modified traction assisted ESD treatment.The average surgical time,intraoperative bleeding volume,hospitalization time,lesion resection status,lesion start labeling to complete dissection time,mucosal exposure to complete dissection time,serum inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8),interleukin-12(IL-12)]levels,serum stress hormone[adrenaline(E),norepinephrine(NE),cortisol(Cor)]levels,and postoperative complications were compared between two groups of patients.Results The average surgical time,intraoperative bleeding,and hospitalization time in the observation group were all lower than those in the control group,and the difference was statistically significant(P<0.05).60 lesions were removed in both groups,and there was no statistically significant difference in the complete lesion removal rate between the observation group and the control group(P>0.05).The observation group had shorter time from lesion marking to complete dissection and from mucosal exposure to complete dissection compared to the control group,and the differences were statistically significant(P<0.05).On the 1st day after surgery,the levels of IL-6,IL-8,IL-12,E,NE,and Cor in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Among the 60 patients,3 experienced intraoperative bleeding,all of which were successfully stopped under endoscopy,and there was no uncontrollable large bleeding during th

关 键 词：改良牵引辅助ESD 早期胃癌 治疗效果 并发症 

分 类 号：R735.2[医药卫生—肿瘤]