内镜下黏膜剥离术与内镜下黏膜切除术治疗胃食管早癌及癌前病变的临床效果分析  

Clinical Effect Analysis of ESD and EMR in the Treatment of Gastroesophageal Early Cancer and Precancerous Lesions

作　　者：陈佼佼 于亚权 CHEN Jiaojiao;YU Yaquan(Department of Gastroenterology,Yangzhou Hongquan Hospital,Yangzhou 225200,Jiangsu,China)

机构地区：[1]扬州洪泉医院消化内科,江苏扬州225200

出　　处：《系统医学》2025年第6期169-171,174,共4页Systems Medicine

摘　　要：目的探讨内镜下黏膜剥离术(endoscopic mucosal dissection,ESD)与内镜下黏膜切除术(endoscopic mu-cosal resection,EMR)治疗胃食管早癌及癌前病变的临床效果。方法非随机选取扬州洪泉医院2020年6月—2024年1月收治的胃食管早癌及癌前病变患者87例为研究对象,根据治疗方案差异分为两组。对照组(n=43)予以EMR治疗,观察组(n=44)予ESD治疗,比较两组病灶切除及手术指标,检测肿瘤标志物水平,统计并发症率。结果观察组整块切除率93.18%(41/44)、完全切除率90.91%(40/44)较对照组的74.42%(32/43)、69.77%(30/43)高,差异有统计学意义(χ^(2)=5.670、6.183,P均<0.05);观察组出血量小于对照组、住院时间短于对照组,切除面积大于对照组,差异有统计学意义(P均<0.05)。术后1月,观察组癌胚抗原、鳞癌抗原水平低于对照组,差异有统计学意义(P均<0.05)。两组并发症率比较,差异无统计学意义(P>0.05)。结论对胃食管早癌及癌前病变予ESD可有效切除病灶,对机体损伤小,可改善肿瘤标志物水平,并发症风险可控。Objective To investigate the clinical effect of endoscopic mucosal dissection(ESD)and endoscopic muco-sal resection(EMR)in the treatment of gastroesophageal early cancer and precancerous lesions.Methods A total of eighty-seven patients with gastroesophageal early cancer and precancerous lesions admitted to Yangzhou Hongquan Hospital from June 2020 to January 2024 were non-randomly selected as research object and divided into two groups according to the difference in treatment plan.The control group(n=43)was given EMR,and the observation group(n=44)was given ESD.The lesion resection,surgical indexes,tumor markers and complication rate were compared.Re-sults The whole resection rate of 93.18%(41/44)and the complete resection rate of 90.91%(40/44)in the observation group were higher than 74.42%(32/43)and 69.77%(30/43)in the control group,and the differences were statistically significant(χ^(2)=5.670,6.183,both P<0.05).The bleeding volume was less than the control group,the length of hospital was shorter than the control group,and the resection area was larger than the control group,the differences were statis-tically significant(all P<0.05).One month after surgery,CES and SCCA were lower in observation group than those in the control group,the differences were statistically significant(both P<0.05).There was no statistically significant dif-ference in complication rate between the two groups(P>0.05).Conclusion ESD can effectively resect the lesion of early gastroesophageal cancer and precancerous lesions,reduce the damage to the body,improve the level of tumor markers,and control the complications.

关 键 词：内镜下黏膜剥离术 内镜下黏膜切除术 早癌 癌前病变 肿瘤标志物 并发症 

分 类 号：R4[医药卫生—临床医学]