早期胃癌的超声内镜诊断及内镜下治疗效果分析

Ultrasonic endoscopic diagnosis and curative effects of endoscopic treatment on early gastric cancer and follow-up analysis

目的分析超声内镜对早期胃癌的诊断价值及内镜黏膜下剥离术治疗效果。方法以我院2011年1月～2013年6月收治的65例早期胃癌患者为研究对象，均经病理检查证实，其中行超声内镜检查及内镜黏膜下剥离术35例为观察组。行外科开腹手术治疗30例为对照组，比较两组治疗效果及随访3年情况。结果观察组行超声内镜检查，分别检出黏膜癌、黏膜下癌11、24例，与术后病理分期结果比较符合率分别为90．9％、91．6％；观察组手术时间、术后下床活动时间和住院时间均显著短于对照组（P〈0．01），两组并发症发生率比较无显著差异（P〉0．05）；观察组3年复发率及存活率分别为2．9％、100．0％，显著低于照组的20．0％、86．7％（P〈0．05）。结论超声内镜检查诊断早期胃癌准确率高，内镜黏膜下剥离术疗效明确，并发症少。能明显降低复发率，3年存活率高，值得临床推广。

Objective To analyze the diagnostic value of endoscopic ultrasonography for early gastric cancer and the curative effects of endoscopic submucosal decollement. Methods 65 cases of early gastric cancer hospitalized between January 2011 and June 2013 were taken as the research objects and all pathologically confirmed. 35 cases receiving endoscopic uhrasonography and endoscopic submucosal decollement were chosen as observation group, and 30 cases receiving surgical laparotomy were chosen as control group. Comparison was made in the curative effects and the three-year follow-up between the two groups. Results Among the 35 patients receiving endoscopic uhrasonography, there were 11 cases of mucosal carcinoma and 24 ones of submucosal carcinoma detected. The coincidence rates with the postoperative pathological staging were 90.9% and 91.6%. The time of operation, postoperative activity time, and length of stay in the observation group were significantly shorter than those in the control group （P 〈 0.01）. There was no significant difference in the incidence of complications between the two groups （P 〉 0.05）. The three-year recurrence rate and survival rate of the observation group were 2.9% and 100.0%, which were significantly lower than those of the control group （20.0% and 86.7%） （P 〈 0.05）. Conclusion Endoscopic ultrasonography for early gastric cancer has a high accuracy. The endoscopic submucosal decollement has certain curative effects and fewer complications, which can significantly reduce the recurrence rate with high three-year survival rate and is worthy of clinical promotion.