胃肠激素变化评估STER与ESD治疗上消化道黏膜下肿瘤的价值  

Comparison of value of STER and ESD in treating upper gastrointestinal submucosal tu⁃mors based on the changes of gastrointestinal hormones

作　　者：张新竹 凌安生 伍平[1] 李峰[1] ZHANG Xinzhu;LING Ansheng;WU Ping;LI Feng(Department of Gastroenterology,Anqing First People's Hospital,Anhui,Anqing,China,246000)

机构地区：[1]安庆市第一人民医院消化内科,安徽安庆246000

出　　处：《分子诊断与治疗杂志》2024年第6期1121-1124,1129,共5页Journal of Molecular Diagnostics and Therapy

基　　金：国家卫生计生委医药卫生科技发展研究中心项目(W2015JZC32)。

摘　　要：目的基于胃肠激素变化,探究评估STER与ESD治疗上消化道黏膜下肿瘤的价值。方法 回顾性分析安庆市第一人民医院消化内科2020年1月至2023年1月收治的70例SMT患者临床资料,根据手术方式分为STER组(n=34,STER切除肿瘤)和ESD组(n=36,ESD剥离肿瘤),比较两组临床疗效、围术期指标、创面恢复情况、胃肠功能恢复情况、胃肠激素水平、并发症。结果 两组临床疗效比较无统计学意义(P>0.05);STER组术中出血量、术后住院天数均少于ESD组,而住院费高于ESD组,差异均有统计学意义(P<0.05);STER组创面长径、创面愈合时间、首次肛门排气时间、首次排便时间均少于ESD组,差异均有统计学意义(P<0.05);STER组胃泌素-17水平低于ESD组,胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ水平高于ESD组,差异有统计学意义(P<0.05);两组手术并发症构成比比较差异无统计学意义(P>0.05)。结论 ESD与STER治疗SMT均有较好的临床疗效。与ESD相比,STER更有助于改善围术期指标与术后胃激素水平,缩短康复进程,且术后并发症少,但住院费用相对较高,建议医生与患者应根据实际情况选择术式。Objective To study and compare the value of STER and ESD in the treatment of upper gastrointestinal submucosal tumors(SMT)based on the changes of gastrointestinal hormones.Methods The clinical data of 70 patients with SMT admitted to department of gastroenterology of Anqing First Peoples Hospital from January 2020 to January 2023 were retrospectively analyzed,and the patients were divided into STER group(n=34,STER resection of tumor)and ESD group(n=36,ESD stripping of tumor)according to surgical methods.The clinical efficacy,perioperative indicators,wound recovery,gastrointestinal function recovery,gastrointestinal hormones levels and complications were compared between the two groups.Results There was no statistical significance in clinical efficacy between the two groups(P>0.05).The intraoperative blood loss and postoperative hospital stay in STER group were less or shorter than those in ESD group,and the hospitalization cost was higher than that in ESD group(P<0.05).The wound length,wound healing time,first anal exhaust time and first defecation time were shorter in STER group than those in ESD group(P<0.05).The level of gastrin-17 in STER group was lower while the levels of pepsinogenⅠand pepsinogenⅡwere higher than those in ESD group(P<0.05).There were no statistical differences in the incidence rates of surgical complications between the two groups(P>0.05).Conclusion Both ESD and STER have good clinical efficacy in the treatment of SMT.Compared with ESD,STER is more helpful to improve perioperative indicators and postoperative gastrointestinal hormones levels and shorten the rehabilitation process,and it has fewer postoperative complications,but the hospitalization cost is relatively high.It is recommended that doctors and patients should choose the surgical method according to the actual situation.

关 键 词：内镜经粘膜下隧道肿瘤切除术 内镜黏膜下剥离术 上消化道黏膜下肿瘤 胃肠激素 

分 类 号：R735[医药卫生—肿瘤]