内镜黏膜剥离术和内镜黏膜切除术对早期胃癌患者胃肠功能影响的比较  

Comparison of effects of endoscopic mucosal dissection and endoscopic mucosal resection on gastrointestinal function in patients with early gastric cancer

作　　者：贺金华 魏佳楠 王丽婷 HE Jinhua;WEI Jianan;WANG Liting(Department of Gastrointestinal Oncology,the First Affiliated Hospital of China Medical University,Shenyang 110002,China)

机构地区：[1]中国医科大学附属第一医院胃肠肿瘤外科,110002

出　　处：《天津医药》2025年第4期407-411,共5页Tianjin Medical Journal

摘　　要：目的比较内镜黏膜剥离术(ESD)和内镜黏膜切除术(EMR)对胃癌早期患者胃肠功能的影响。方法将86例早期胃癌患者按照治疗方式不同分为ESD组和EMR组,每组43例。比较2组手术相关指标:手术时长、术中出血量、术后排气时间、住院时间;术前、术后1个月炎性因子:白细胞介素(IL)-6、IL-8;胃肠激素指标:胃动素(MTL)、胃泌素(GAS);凋亡相关因子:抗凋亡因子Livin、表皮生长因子(EGF);术前、术后3个月、术后6个月欧洲癌症研究治疗组织(EORTC)生命质量测定量表(QLQ-C30)评分;不良反应。结果与EMR组比较,ESD组手术时长、术后排气时间、住院时间均较短,术中出血量减少(P<0.05);和术前相比,术后2组IL-6、IL-8、MTL、GAS、Livin、EGF均下降(P<0.05);术后1个月时,与EMR组相比,ESD组IL-6、IL-8、Livin和EGF降低,而MTL、GAS升高(P<0.05);2组术后3个月和术后6个月时的QLQ-C30分值均较术前升高,术后6个月时量表分值更高,且ESD组的量表分值在术后3个月和术后6个月时均高于EMR组(P<0.05);ESD组不良反应总发生率低于EMR组(4.65%vs.20.93%)(P<0.05)。结论相较EMR,ESD能够更有效改善早期胃癌患者的胃肠功能、提高生活质量、降低炎症及凋亡相关因子水平。Objective To compare the effects of endoscopic mucosal dissection(ESD)and endoscopic mucosal resection(EMR)on gastrointestinal function in patients with early gastric cancer.Methods According to different treatment methods,86 patients with early gastric cancer were divided into the ESD group and the EMR group,with 43 cases in each group.The operation duration,postoperative exhaust time and hospital stay of the two groups were observed and compared.Inflammatory factors including interleukin(IL-6)and IL-8 before surgery and 1 month after surgery were compared between the two groups of patients.Gastrointestinal hormone indexes including motilin(MTL),gastrin(GAS),apoptosis-related factors including anti-apoptotic factor(Livin)and epidermal growth factor(EGF),European Organization for Research and Treatment of Cancer(EORTC)Quality of Life Scale(QLQ-C30)score before surgery,3 months after surgery and 6 months after surgery were compared between the two groups of patients.An adverse reaction was also compared between the two groups of patients.Results The operation time,postoperative exhaust time and hospital stay were shorter in the ESD group than those of the EMR group(P<0.05),and the intraoperative blood loss was significantly less than that of the EMR group(P<0.05).Compared with the pre-operation,serological indexes such as IL-6,IL-8,MTL,GAS and Livin were decreased after surgery in the two groups(P<0.05).One month after surgery,IL-6,IL-8 and Livin were decreased,and MTL and GAS were increased in the ESD group compared with those of the EMR group(P<0.05).QLQ-C30 scores were higher at 3 months and 6 months after operation than those before operation in both groups,and the QLQ-C30 scores of the two groups were significantly higher at 6 months after operation(P<0.05).The scale scores of the ESD group were significantly higher than those of the EMR group at 3 months and 6 months after operation(P<0.05).The overall incidence rates of adverse reactions were(4.65%)in the ESD group and(20.93%)in the EMR group(P<0.05).Conclu

关 键 词：胃肿瘤 内窥镜黏膜切除术 生活质量 LIVIN 胃肠功能 

分 类 号：R735.2[医药卫生—肿瘤] R61[医药卫生—临床医学]