内镜黏膜下剥离术在胃肠道早癌及癌前病变治疗中的应用研究

Endoscopic submucosal dissection in the treatment of early gastrointestinal cancer and precancerous lesions

目的探讨在胃肠道早癌及癌前病变患者治疗中引入内镜下黏膜剥离术(ESD)的临床作用。方法回顾性分析162例胃肠道早癌及癌前病变患者的病历资料,其中采用传统手术治疗者共有95例,将其记为对照组;采用ESD术式治疗者共有67例,将其记为观察组。观察指标为整块完整切除率、治愈性切除率、手术相关指标和随访结果。结果 2组整块完整切除率、治愈性切除率无显著性差异(P>0.05);观察组术中出血量、手术时间、血流动力学指标变化量、术后并发症发生率均显著低于对照组(P<0.05);2组术后12个月病死率比较差异无显著性(P>0.05)。结论ESD在胃肠道早癌及癌前病变患者的治疗中作用显著,且创伤小,预后情况与传统开腹手术相似。

Objective To investigate the clinical effect of endoscopic submucosal dissection（ESD）in patients with earlygastrointestinal cancer and precancerous lesions. Methods a retrospective analysis of medical records of early gastrointestinalcancer and precancerous lesions in patients with 162 cases,the traditional surgical treatment were 95 cases,the control group istreated by ESD procedure;there werea total of 67 cases,which will be recorded in the observation group. The overall resectionrate,curative resection rate,operative correlation index and follow-up results were observed. Results the whole groupcomplete resection rate,resection rate was no significant difference （P〉0.05） ;the amount of bleeding,operation time,amountof change in hemodynamic parameters corresponding to the data rate of postoperative complications were significantly lower thanthe control group （P〈0.05） ;the two groups were compared after 12 month mortality had no significant difference（P〉0.05） .Conclusion ESD plays an important role in the treatment of patients with early gastrointestinal cancer and precancerouslesions, and the prognosis is similar to that of traditional laparotomy.