尼龙绳圈套扎闭合在胃底间质瘤患者内镜下全层切除术中的应用效果  

Application effect of nylon rope loop closure in endoscopic full-thickness resection for gastric fundus stromal tumor

作　　者：许家珂 赵坚敏 丰烨 Xu Jiake;Zhao Jianmin;Feng Ye(Department of Gastroenterology,the Second People's Hospital of Kunshan,Suzhou 215300,China)

机构地区：[1]昆山市第二人民医院消化内科,苏州215300

出　　处：《肿瘤研究与临床》2025年第1期50-54,共5页Cancer Research and Clinic

基　　金：江苏省自然科学基金(BK20201230)。

摘　　要：目的探讨尼龙绳圈套扎闭合在胃底间质瘤患者内镜下全层切除术(EFTR)中的应用效果。方法回顾性队列研究。选取2019年1月至2023年6月昆山市第二人民医院收治的98例胃底间质瘤患者,其中47例应用EFTR(对照组),51例应用尼龙绳圈套扎闭合联合EFTR(观察组),比较两组手术相关指标、营养状况指标、免疫指标、并发症发生情况及随访1年的复发率。结果两组患者性别、年龄、肿瘤长径、病程时间、体质量指数差异均无统计学意义(均P>0.05)。观察组手术时间[(50±5)min比(70±6)min]、住院时间[(6.8±1.0)d比(8.6±1.7)d]、肛门排气时间[(1.05±0.21)d比(1.39±0.23)d]均短于对照组,出血量低于对照组[(45±5)ml比(80±6)ml],差异均有统计学意义(t值分别为18.28、6.31、7.65、29.28,均P<0.05)。术后3个月,观察组营养状况指标前清蛋白、转铁蛋白、清蛋白水平均高于对照组(均P<0.05);术后3个月,观察组免疫指标CD4+水平、CD4+/CD8+均低于对照组,CD8+水平高于对照组,差异均有统计学意义(均P<0.05)。观察组患者发热、腹膜炎各1例,对照组患者发热4例,迟发性出血2例,腹膜炎2例,迟发性穿孔1例;观察组并发症发生率低于对照组[3.92%(2/51)比19.15%(9/47)],差异有统计学意义(χ2=5.69,P=0.017)。随访1年,观察组复发率低于对照组[1.96%(1/51)比12.77%(6/47)],差异有统计学意义(χ2=4.31,P=0.038)。结论尼龙绳圈套扎闭合有助于加快胃底间质瘤EFTR患者康复,提高患者免疫力和改善营养状况,并减少并发症和复发。ObjectiveTo investigate the application effect of nylon rope loop closure in endoscopic full-thickness resection(EFTR)for patients with gastric fundus stromal tumor.MethodsA retrospective cohort study was conducted.A total of 98 patients with gastric fundus stromal tumor admitted to the Second People's Hospital of Kunshan from January 2019 to June 2023 were selected,of which 47 were treated with EFTR(the control group)and 51 were treated with nylon rope closure combined with EFTR(the observation group).The operation related index,nutritional status index,immune index,complications and the recurrence rate of 1-year follow-up were compared between the 2 groups.ResultsThere were no statistically significant differences in gender,age,tumor diameter,the disease duration and body mass index between the observation group and the control group(all P>0.05).The operation time[(50±5)min vs.(70±6)min],hospital stay[(6.8±1.0)d vs.(8.6±1.7)d]and anal exhaust time[(1.05±0.21)d vs.(1.39±0.23)d]in the observation group were all shorter than those in the control group;the amount of blood loss in the observation group was lower than that of the control group[(45±5)ml vs.(80±6)ml],and the differences were statistically significant(t values were 18.28,6.31,7.65,29.28,respectively,all P<0.05).The levels of nutritional indexes prealbumin,transferrin and albumin in the observation group were higher than those in the control group 3 months after surgery(all P<0.05);immune indexes CD4+level and CD4+/CD8+in the observation group were lower than those in the control group 3 months after surgery,and the level of CD8+in the observation group was higher than that in the control group,and the differences were statistically significant(all P<0.05).In the observation group,1 case had fever and 1 case had peritonitis,while in the control group,4 cases had fever,2 cases had delayed hemorrhage,2 cases had peritonitis and 1 case had delayed perforation.The incidence of complications in the observation group was lower than that in the control

关 键 词：胃肠道间质肿瘤 胃底 尼龙绳圈套扎术 内镜全层切除术 

分 类 号：R735.2[医药卫生—肿瘤]