内镜黏膜下剥离术与完全腹腔镜手术治疗患者早期胃癌的效果及对并发症和近期预后的影响  

The Effects of Endoscopic Submucosal Dissection and Complete Laparo⁃scopic Surgery on Early Gastric Cancer in Patients and Their Impact on Complications and Short-term Prognosis

作　　者：胡翠梨 欧阳德伟 何敬先 HU Cuili;OUYANG Dewei;HE Jingxian(Wenshang County People's Hospital,Jining,Shandong,272500,China)

机构地区：[1]汶上县人民医院,山东济宁272500

出　　处：《中外医疗》2025年第4期40-43,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨对于早期胃癌,分别应用内镜黏膜下剥离术(endoscopic submucosal dissection, ESD)、完全腹腔镜手术对疾病疗效和预后的影响。方法 随机选取2023年1月—2024年3月汶上县人民医院收治的80例早期胃癌患者为研究对象,按照不同手术分组,每组40例。对照组采用的腹腔镜的手术,观察组患者采取ESD手术治疗。对比两组的临床疗效,两组术前、术后1 d、术后3 d的血清C反应蛋白(C-reactive protein,CRP)与白细胞介素-6(interleukin-6, IL-6)指标变化,两组术后并发症及复发率。结果 治疗总有效率观察组高于对照组[95.00%(38/40)比77.50%(31/40)],差异有统计学意义(χ^(2)=5.164,P<0.05)。相较于术前,术后1 d两组CRP、IL-6均升高;相较于术后1 d,术后3 d两组CRP、IL-6均降低,差异均有统计学意义(P均<0.05)。术后并发症总发生率观察组比对照组更低[5.00%(2/40)比22.50%(9/40)],差异有统计学意义(χ^(2)=5.164,P<0.05)。随访6个月后,相较于对照组,复发率观察组更低,差异有统计学意义(P<0.05)。结论 对于早期胃癌采取ESD手术治疗的效果满意,炎性应激上同ESD与腹腔镜手术基本相当,但ESD手术并发症及随访复发率更低。Objective To explore the effect of endoscopic submucosal dissection(ESD)and complete laparoscopic sur⁃gery on the efficacy and prognosis of early gastric cancer.Methods From January 2023 to March 2024,80 patients with early gastric cancer received by Wenshang County People's Hospital were randomly selected as the research ob⁃jects.According to different surgical groups,40 cases in each group.The control group was treated with laparoscopic surgery,and the observation group was treated with ESD surgery.The clinical efficacy of the two groups was com⁃pared.The changes of serum C-reactive protein(CRP)and interleukin-6(IL-6)indexes before operation,1 d and 3 d after operation,postoperative complications and recurrence rate of the two groups were compared.Results The total ef⁃fective rate of treatment in the observation group was higher than that in the control group[95.00%(38/40)vs 77.50%(31/40)],the difference was statistically significant(χ^(2)=5.164,P<0.05).Compared with before operation,the levels of CRP and IL-6 in the two groups increased at 1 day after operation,compared with 1 d after operation,the levels of CRP and IL-6 in the two groups decreased at 3 d after operation,and the differences were statistically significant(all P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group[5.00%(2/40)vs 22.50%(9/40)],and the difference was statistically significant(χ^(2)=5.164,P<0.05).After 6 months of follow-up,the recurrence rate of the observation group was lower than that of the control group,and the difference was statistically significant (P<0.05).Conclusion The effect of ESD surgery for early gastric cancer is satisfac⁃tory, and the inflammatory stress is similar to that of ESD and laparoscopic surgery, but the complications and recur⁃rence rate of ESD surgery are lower.

关 键 词：早期胃癌 内镜黏膜下剥离术 完全腹腔镜手术 临床疗效 炎性应激 并发症 近期预后 

分 类 号：R735.2[医药卫生—肿瘤]