内镜下黏膜切除术与电凝切除术治疗不同直径扁平型病灶的比较研究

Comparative Study of Endoscopic Mucosal Resection and Electrical Coagulation Resection in Treating Different Diameter of Flat Lesions

目的：研究内镜下黏膜切除术与电凝切除术治疗不同直径扁平型病灶的效果。方法：将2011年1月-2013年3月期间我院收治的90例胃扁平型息肉患者纳入研究,根据切除方法不同分为接受内镜下黏膜切除术的观察组和接受电凝切除术治疗的对照组,分析直径〈1cm和直径≥1cm病灶的切除情况和远期生活质量。结果：（1）直径〈1cm病灶：两组患者的手术时间、术中使用钛夹止血的例数、并发黏膜小穿孔的例数、术后进食流质时间以及远期复发例数无差异;（2）直径≥1cm病灶：观察组患者的手术时间、术后进食流质时间短于对照组,术中使用钛夹止血的例数、并发黏膜小穿孔的例数以及远期复发例数少于对照组;（3）生活质量：观察组患者的自我实现、健康责任、运动、营养、人际关系、应对压力评分均高于对照组。结论：内镜下黏膜切除术在切除直径〉1cm扁平病灶时的临床价值尤为显著,具有切除彻底、并发症率和复发率低、生活质量恢复好的优势。

Objective： To study the effect of endoscopic mucosal resection and electrical coagulation resection in treating different diameter of flat lesions.Methods：90 cases of patients with flat lesions from 2011 January-2013 March were enrolled and divided into observation group given endoscopic mucosal resection and control group given electrical coagulation resection.Then resection condition and long-term life quality of diameter〈1 cm and diamete≥1 cm lesion were analyzed.Results：（1） diameter1 cm lesion：there were no statistical difference between two groups of operation time,cases of using titanium clip to stop bleeding,cases of mucosal perforation,eating liquid time and recurrence cases;（2） diameter ≥ 1 cm lesions：operation time and eating liquid time of observation group were shorter than control group,cases of using titanium clip to stop bleeding,mucosal perforation and recurrence were less than control group;（3） long-term life quality：self realization,exercise,nutrition,health responsibility,interpersonal relationship,respond to stress scores of observation group were higher than control group.Conclusion：Clinical value of endoscopic mucosal resection is particularly significant in treating lesion with diameter ≥ 1 cm for it has advantage of complete resection,low complication rate recurrence rate,high quality of life.