早期胃癌经动脉介入治疗与内镜黏膜下剥离术治疗术后并发症相关因素分析

Analysis of Factors Related to Complications After Transarterial Interventional Therapy and Endoscopic Submucosal Dissection for Early Gastric Cancer

目的分析探讨采用经动脉介入治疗与内镜黏膜下剥离术(ESD)治疗早期胃癌的术后并发症及相关因素,为早期胃癌的治疗及预后提供参考和思路。方法以我院2014年7月至2016年12月间收治的65例早期胃癌患者作为研究对象,分为对照组(31例)和观察组(34例)。对照组单独给予ESD治疗;观察组给予经动脉介入与ESD联合治疗。观察并统计患者手术成功率及术后并发症出现情况,分析引发并发症的相关因素。结果联合经动脉介入化疗和ESD治疗的患者总有效率略优于单独给予ESD治疗的患者,住院时间也较短,但差异无统计学意义(P>0.05);联合治疗法患者生存质量评分较高,差异有统计学意义(P<0.05);联合治疗显著增加患者出现术后并发症的比例,差异有统计学意义(P<0.05)。对照组与观察组发生术后感染、穿孔、迟发性出血、重要脏器(心、肝、肾)功能异常等并发症比例差异无统计学意义(P>0.05);观察组发生消化道反应比例显著高于对照组,差异有统计学意义(P<0.05)。结论联合治疗法治疗早期胃癌时总体疗效略优于单独应用ESD法。但联合治疗会引起较高的术后并发症比例。联合治疗不会降低ESD术常导致的穿孔和出血等并发症比例,但联合治疗的胃肠道反应显著增多,值得临床治疗时引起重视。

Objective To analyze and investigate the postoperative complications and related factors of transarterial interventional therapy and endoscopic submucosal dissection(ESD)in the treatment of early gastric cancer,and to provide references and ideas for the treatment and prognosis of early gastric cancer.Methods A total of 65 patients with early gastric cancer admitted to our hospital from July 2014 to December 2016 were selected as study subjects and divided into control group(n=31)and observation group(n=34).The control group was treated with ESD alone,while the observation group was given transarterial intervention combined with ESD.The success rate of operation and the occurrence of postoperative complications were observed and analyzed,and the related factors that lead to complications were analyzed.Results The total effective rate of patients with combined transarterial chemotherapy and ESD therapy was slightly better than that of patients treated with ESD alone,and the hospitalization time was also shorter,but the difference was not statistically significant(P>0.05);The scores of quality of life in patients with combined therapy were higher,statistically significant(P<0.05);Combined therapy significantly increased the incidence of postoperative complications,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative infection,perforation,delayed hemorrhage and abnormal function of important organs(heart,liver,kidney)between the control group and the observation group(P>0.05);The rate of digestive tract reaction in the observation group was significantly higher than that in the control group(P<0.05).Conclusions The overall efficacy of combined therapy in the treatment of early gastric cancer is slightly better than that of ESD alone.However,combined therapy can cause a higher rate of postoperative complications.Combination therapy does not reduce the rate of complications such as perforation and hemorrhage in ESD,but the gastrointestinal reaction in combination therapy is significantly increased,which deserves attention in clinical treatment.