62例消化道早期癌肿患者经内镜诊断和治疗的临床观察

Clinical observation of 62 patients with early stage digestive tract tumors undergoing endoscopic diagnosis and treatment

目的探讨消化内镜对早期消化道癌肿患者的诊断和治疗价值。方法选择2014年1月—2016年5月台州市第一人民医院消化内科收治的62例早期消化道癌肿患者。按照随机数字表法,将其分为对照组(30例)及观察组(32例)。对照组采用传统白光内镜诊断方法及传统外科手术治疗方法;观察组采用电子染色胃镜和超声胃镜协助诊断和治疗。比较患者治疗后的临床检出率、影像质量评分、临床疗效、手术相关指标以及术后并发症情况。结果 (1)观察组检出率(87.5%,28/32)明显大于对照组(63.33%,19/30),P<0.05。(2)观察组影像质量各指标评分均大于对照组(P<0.05)。(3)治疗后,观察组有效率为43.75%(14/32),疾病控制率为90.63%(29/32)。对照组有效率为23.33%(7/30),疾病控制率为73.33%(22/30)。2组疗效对比,差异有统计学意义(P<0.05)。(4)2组患者术后各手术相关指标均优于对照组(P<0.05)。(5)治疗后,观察组并发症发生率(3.13%,1/32)明显低于对照组(20.00%,6/30)(P<0.05)。结论消化内镜技术能够提高早期消化道癌肿的临床检出率,提高影像质量评分从而提高诊断的准确率,同时采用消化内镜治疗消化道早期癌肿,能够有效提高患者的治疗有效率和疾病控制率,优化术后手术指标,减少术后并发症的发生。

Objective To investigate the value of digestive endoscopy in the diagnosis and treatment of early digestive tract cancer. Methods From January, 2014 to May, 2016, 62 patients with early stage digestive tract tumors were se- lected from Department of Gastroenterology, Taizhou First People＇ s Hospital. They were divided into control group （ n = 30） and observation group （n = 32 ） according to random number table method. The control group received traditional white light endoscope and conventional surgical treatment, while the observation group （32 cases ） received electronic gastroseope and ultrasonic gastroscope to assist in the diagnosis and treatment. After the treatment, the clinical detection rate, image quality score, clinical efficacy, operation related indexes and postoperative complications were compared be- tween the two groups. Results （1） The detection rate of the observation group （ 87.5% , 28/32 ） was significantly higher than that of the control group （63.33% , 19/30） , P 〈 0.05. （2） The scores of image quality in the observation group were higher than those in the control group, P 〈 0.05. （3） After the treatment, the efficient and disease control rates in the observation group were 43.75% （14/32） and 90.63% （29/32） , which were significantly higher than those in the control group [23.33% （7/30） and 73.33% （22/30） ], P 〈0.05. （4） The relative indexes of the observation group af- ter operation were better than those in the operation, P 〈 0.05. （5） After the treatment, the complication rate of the obser- vation group （3. 13% , 1/32） was significantly lower than that in the control group （20.00% , 6/30）, P 〈 0.05. Conclusion Digestive endoscopy can improve the detection rate of early digestive tract cancer, image quality score and diagnostic accuracy ; the early treatment of digestive tract cancer by gastrointestinal endoscopy can also improve the thera- peutic efficiency ratio and disease control rate, optimize the postoperative surgical indicators, and reduce the postopera- tive complications.