内镜下黏膜剥离术治疗早期肠癌及癌前病变的疗效研究  

Study on the effi cacy of endoscopic mucosal dissection in the treatment of early colorectal cancer and precancerous lesions

作　　者：王红旗 Wang Hongqi(Colorectal Medicine Department of Nanjing Gangtai Traditional Chinese Medicine Hospital,Jiangsu Nanjing 210019,China)

机构地区：[1]南京肛泰中医院肛肠科,江苏南京210019

出　　处：《临床普外科电子杂志》2025年第1期64-68,共5页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的研究内镜下黏膜剥离术治疗早期肠癌及癌前病变的临床疗效以及安全性。方法选择南京肛泰中医院在2022年1月至2023年12月收治的60例早期肠癌及癌前病变患者,按照随机数字表法分组,对照组(n=30)实施内镜下黏膜切除术治疗,观察组(n=30)实施内镜黏膜下剥离术治疗,比较两组患者的各项围手术期指标,手术前后炎症因子水平、应激反应指标和各项生化指标。结果观察组患者的手术时间、恢复排气时间、镇痛时间、住院时间、切口长度均短于对照组,术中出血量少于对照组,差异均有显著性(P<0.05)。术前,两组患者的炎症因子水平、应激反应指标及生化指标均无显著差异(P>0.05)。术后,观察组患者的炎症因子水平、应激反应指标均低于对照组,差异均有显著性(P<0.05);术后,观察组患者的胃动素、生长抑素和血管细胞黏附分子1均低于对照组,差异有显著性(P<0.05)。结论早期肠癌及癌前病变患者通过消化内镜黏膜下剥离术治疗,可改善其炎症因子水平以及应激反应程度。Objective To investigate the clinical effi cacy and safety of endoscopic mucosal dissection in the treatment of early colorectal cancer and precancerous lesions.Method Sixty patients with early colorectal cancer and precancerous lesions admitted to Nanjing Anal Tai Traditional Chinese Medicine Hospital from January 2022 to December 2023 were randomly divided into two groups using a random number table.The control group(n=30)underwent endoscopic mucosal resection,while the observation group(n=30)underwent endoscopic submucosal dissection.The perioperative indicators,levels of infl ammatory factors,stress response indicators,and biochemical indicators before and after surgery were compared between the two groups of patients.Result The surgical time,re-covery time,analgesia time,hospitalization time,and incision length of the observation group were all shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,with signifi cant diff erences(P<0.05).Before surgery,there were no signifi cant diff erences in the levels of infl ammatory factors,stress response indicators,and biochemical indicators between the two groups of patients(P>0.05).After surgery,the levels of infl ammatory factors and stress response indicators in the observation group were signifi cantly low-er than those in the control group(P<0.05);After surgery,the levels of motilin,somatostatin,and vascular cell adhesion molecule-1 in the observation group were signifi cantly lower than those in the control group(P<0.05).Conclusion Early stage colon cancer and precancerous lesions can be treated with submucosal dissection under di-gestive endoscopy to improve their infl ammatory factors and stress response.

关 键 词：内镜黏膜下剥离术 癌前病变 应激反应程度 炎症因子 

分 类 号：R73[医药卫生—肿瘤]