超声内镜联合改良内镜下黏膜切除术在直肠神经内分泌肿瘤治疗中的效果分析  

Preliminary clinical exploration of endoscopic ultrasound combined with modified endoscopic mucosal resection in the treatment of rectal neuroendocrine tumors

作　　者：罗萍[1] 刘爱民[1] 易志强 罗乔木 魏沙 况晶 唐静[1] LUO Ping;LIU Aimin;YI Zhiqiang;LUO Qiaomu;WEI Sha;KUANG Jing;TANG Jing(Department of Gastroenterology,Chongqing University Fuling Hospital,Chongqing 408099,China)

机构地区：[1]重庆大学附属涪陵医院消化内科,重庆408099

出　　处：《重庆医学》2025年第4期893-897,共5页Chongqing Medical Journal

基　　金：重庆市涪陵区科卫联合医学科研项目(2022KWLH003)。

摘　　要：目的探讨超声内镜(EUS)联合改良内镜下黏膜切除术(EMR)在直肠神经内分泌肿瘤(RNETs)治疗中的可行性及安全性。方法选取2021年12月至2023年6月于该院消化内科行肠镜检查诊断为RNETs的48例患者为研究对象。将患者分为研究组(EUS联合改良EMR,n=16)、对照组1(传统EMR,n=16)对照组2[内镜黏膜下剥离术(ESD),n=16];观察各组手术时间、R0切除率、术后并发症发生情况,术后3、6个月随访超声内镜明确有无复发。结果研究组手术时间[(17.813±0.379)min]较对照组2手术时间[(36.250±3.296)min]明显缩短,差异有统计学意义(P<0.05),但与对照组1[(16.375±1.996)min]比较,差异无统计学意义(P>0.05)。研究组并发症发生率(6.2%)明显低于对照组2(37.5%),差异有统计学意义(P<0.05);研究组并发症发生率与对照组1(12.5%)比较,差异无统计学意义(P>0.05)。研究组R0切除率(93.8%)明显高于对照组1(62.5%)、对照组2(75.0%),差异有统计学意义(P<0.05)。结论EUS联合改良EMR在RNETs治疗方面较EMR及ESD更具有优势,具有一定的可行性及安全性。Objective To investigate the clinical feasibility and safety of endoscopic ultrasonography(EUS)combined with modified endoscopic mucosal resection(EMR)in the treatment of rectal neuroendocrine tumors(RNETs).Methods A total of 48 patients diagnosed with RNETs by colonoscopy in the department of gastroenterology in this hospital from December 2021 to June 2023 were selected as the study objects.Patients were randomly divided into the study group(EUS combined with modified EMR,n=16),the control 1 group(traditional EMR,n=16)and the control 2 group[endoscopic submucosal dissection(ESD),n=16].The operation time,R0 resection rate and postoperative complications of each group were observed.Endoscopic ultrasonography was followed up 3 and 6 months after surgery to determine whether there was any recurrence.Results The operative time of the study group[(17.813±0.379)min]was significantly shorter than that of the control 2 group[(36.250±3.296)min],the difference was statistically significant(P<0.05),but compared with the control 1 group[(16.375±1.996)min],there was no significant difference(P>0.05).The incidence of complications in the study group(6.2%)was significantly lower than that in the control 2 group(37.5%),the difference was statistically significant(P<0.05).while the incidence of complications in the study group was not significantly higher than that in the control 1 group(12.5%,P>0.05).R0 removal rate in the study group(93.8%)was significantly higher than that in the control 1 group(62.5%)and the control 2 group(75.0%),the difference was statistically significant(P<0.05).Conclusion EUS combined with modified EMR has more advantages than EMR and ESD in the treatment of RNETs,and has certain feasibility and safety,which is convenient for clinical application.

关 键 词：直肠神经内分泌肿瘤 超声内镜 内镜下黏膜切除术 内镜黏膜下剥离术 效果分析 

分 类 号：R572.2[医药卫生—消化系统]