内镜下黏膜切除术(EMR)在消化道黏膜隆起性病变中的临床应用

Clinical Application of EMR in the Eminence Lesions of Digestive Tract

目的分析探讨在消化道黏膜隆起性病变中使用内镜下黏膜切除术(EMR)的临床应用效果。方法将2016年6月—2017年11月收治的76例共126处消化道粘膜隆起性病变患者作为研究对象,根据患者具体情况为其进行内镜下黏膜切除术(EMR)或者内镜下黏膜分片切除术(EPMR),对其临床治疗情况进行观察分析。结果72例患者接受了EMR治疗,有2例患者没能完全切除,术后进行了外科手术治疗,治愈率为97.22%(70/72);4例患者病灶大于2.0 cm,接受了EPMR,7处隆起全部完全切除,治愈率为100.00%(4/4), 76例患者中有4例(5.26%)在术中有少量出血情况,及时治疗后成功止血。术中及术后无穿孔情况出现。病理检查结果显示72处为良性腺瘤,29处为增生性息肉,12处为炎性息肉,10处为不典型增生,2处为黏膜内癌,1处为黏膜下层癌。对患者进行术后6个月复查,均无病变残留或复发情况。结论为消化道黏膜隆起性病变患者进行内镜指导下的黏膜切除术具有较好的治疗效果,且并发症少,具有临床推广应用价值。

Objective To analyze and study the clinical application effect of EMR in the eminence lesions of digestive tract. Methods 76 cases of patients with 126 eminence lesions of digestive tract admitted and treated in our hospital from June 2016 to November 2017 were selected and divided into the EMR o EPMR according to the specific conditions, and the clinical treatment conditions were observed and analyzed. Results 72 cases of patients were treated with EMR, the lesions of 2 cases were not totally cut off, and the patients were for surgical surgery after surgery, and the cure rate was 97.22%（ 70/72）; and the lesions of 4 cases were more than 2.0 cm, receiving the EPMR, and the eminence lesions of 7 cases were totally cut off, and the cure rate was 100.00%（ 4/4）, and 4 cases（ 5.26%） of 76 cases had less bleeding, successfully stopped after timely treatment. There was no perforation in and after surgery, and the pathological examination results showed that there were 72 benign adenomas, 29 hyperplastic polyps, 12 inflammatory polyps, 10 atypical hyperplasia, 2 intramucosal carcinoma and 1 submucous carcinoma. The reexamination of patients in 6 months after surgery showed that there was no lesion residual or recurrence. Conclusion The treatment effect of endoscopy-guided mucosectomy in patients with eminence lesions of digestive tract is better, with few complications,and it is worth promotion and application.