内镜下套扎术(EVL)治疗胃肠道黏膜下病变疗效及安全性观察

Endoscopic ligation operation safety and effectiveness to observe the treatment of gastrointestinal submucosal lesions

目的观察内镜下套扎术(EVL)治疗胃肠道黏膜下病变的安全性及疗效。方法将85例(102处黏膜下病变)行内镜下套扎术的患者设为观察组,将同期72例(85处黏膜下病变)行内镜黏膜下剥离术(ESD)的患者作为对照组,回顾性比较2组患者术中出血情况及穿孔发生率。随访6个月,复查病变消除情况。结果 2组手术成功率均为100%。观察组术中出血发生率、穿孔发生率及住院时间均低于对照组,差异有统计学意义(P<0.05)。6个月后门诊内镜复查,观察组痊愈率为97.65%,对照组为100%,差异无统计学意义(P>0.05)。结论 EVL治疗胃肠道黏膜下病变可达到与EMR相同的疗效,但术中出血少,患者住院时间短,是安全微创的方法,但应用时要严格掌握适应证。

Objective To observe the endoscopic ligation operation （ EVL） the safety and efficacy of treatment of gastrointestinal sub-mucosal lesions. Methods Using the retrospective method 85 cases of submucosal lesions （102） line of endoscopic ligation surgery patients as observation group, 72 cases of submucosal lesions （85） over the same line （ESD） to endoscopic submucosal dissection surgery patients as con-trol group, compared two groups of patients the incidence of intraoperative bleeding, perforation; All patients were followed up for 6 months. Results The success rate of the 2 groups were both 100%. The incidence of bleeding in the observation group, the incidence of perforation and hospital stay were lower than those in the control group, the difference was statistically significant （P〈0. 05 ） . After 6 months,the recovery rate was 97. 65% in the observation group and the control group was 100% , the difference was not statistically significant （P 〉0. 05）. Conclusion EVL under the treatment of gastrointestinal mucosa lesions can achieve the same as the EMR of curative effect, but there was some advantage such as less bleeding, shorter hospitalization time, which are safe and minimally invasive method, but when applied strictly grasp the indications.