早期胃癌和癌前病变患者进行内镜黏膜下剥离术治疗的效果  

Efficacy of Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer and Precancerous Lesions

作　　者：张廷光[1] 徐慧 洪森 ZHANG Tingguang;XU Hui;HONG Sen(Department of Gastroenterology,Zoucheng People's Hospital,Zoucheng Shandong 273500,China;Department of Gastroenterology,the Fifth People's Hospital of Jinan,Jinan Shandong 250000,China)

机构地区：[1]邹城市人民医院消化内科,山东邹城273500 [2]济南市第五人民医院消化内科,山东济南250000

出　　处：《中国卫生标准管理》2024年第24期136-139,190,共5页China Health Standard Management

摘　　要：目的探究与分析早期胃癌和癌前病变患者进行内镜黏膜下剥离术治疗的近期疗效。方法回顾性分析邹城市人民医院2020年3月—2022年5月收治的早期胃癌以及癌前病变患者60例的临床资料,按照不同手术治疗方法分为传统开腹手术组以及内镜黏膜下剥离术组,每组30例,对比2组疗效、围手术期指标以及并发症发生率,同时对比术后生活质量评分。结果传统开腹手术组术后并发症发生率为26.67%,内镜黏膜下剥离术组术后并发症发生率为3.33%,内镜黏膜下剥离术组的手术时间、住院时间、下床活动时间、术中出血量、总有效率分别为(75.21±22.36)min、(7.15±1.36)d、(1.65±0.88)d、(155.21±35.99)mL、86.67%,总体健康评分(89.77±3.54)分,传统开腹手术组的手术时间、住院时间、下床活动时间、术中出血量、总有效率分别为(125.10±22.51)min(、13.91±2.54)d、(3.98±1.69)d、(208.32±42.36)mL、60.00%,总体健康评分(65.98±2.36)分,内镜黏膜下剥离术组与传统开腹手术组相比临床总有效率较高、手术时间较短、住院时间较短、下床活动时间较短、术中出血量较少,术后并发症发生率较低,生活质量评分均较高,差异有统计学意义(P<0.05)。结论实施内镜黏膜下剥离术治疗早期胃癌和癌前病变可获得更好的围手术期指标,治疗效果更好,生活质量更高,术后并发症风险较低,安全性高。Objective To evaluate the short-term efficacy of endoscopic submucosal dissection in treating early gastric cancer and precancerous lesions.Methods From March 2020 to May 2022,a retrospective analysis was conducted on the clinical data of 60 patients with early gastric cancer and precancerous lesions who were admitted to Zoucheng People's Hospital.According to different surgical treatment methods,they were divided into the traditional open surgery group and the endoscopic submucosal dissection group,with 30 cases in each group.The efficacy,perioperative indicators and incidence of complications of the two groups were compared,and the postoperative quality of life scores were also compared at the same time.Results The incidence of postoperative complications in the traditional open surgery group was 26.67%,while that in the endoscopic submucosal dissection(ESD)group was 3.33%.The operation time,hospitalization time,time to get out of bed,intraoperative blood loss,and intraoperative blood loss in the ESD group were(75.21±22.36)min,(7.15±1.36)d,(1.65±0.88)d,(155.21±35.99)mL,and 86.67%respectively,and the overall health score was(89.77±3.54)points.The operation time,hospitalization time,time to get out of bed,intraoperative blood loss,and intraoperative blood loss in the traditional open surgery group were(125.10±22.51)min,(13.91±2.54)d,(3.98±1.69)d,(208.32±42.36)mL,and 60.00%respectively,and the overall health score was(65.98±2.36)points.Compared with the traditional open surgery group,the ESD group had a higher clinical total effective rate,shorter operation time,shorter hospitalization time,shorter time to get out of bed,less intraoperative blood loss,lower incidence of postoperative complications,and higher quality of life score,and the differences were statistically significant(P<0.05).Conclusion The implementation of endoscopic submucosal dissection in the treatment of early gastric cancer and precancerous lesions can achieve better perioperative indexes,better quality of life,and high safety.

关 键 词：早期胃癌 癌前病变 内镜黏膜下剥离术 近期疗效 围手术期指标 并发症 

分 类 号：R735[医药卫生—肿瘤]