高频小探头超声内镜评估胃早癌ESD术前安全性的研究

Study on the preoperative safety of high frequency small probe endoscopic ultrasonography in evaluating ESD of early gastric cancer

目的分析高频小探头超声内镜(endoscopic ultrosound,EUS)对内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)安全性进行术前评估的价值。方法选取2017年1月至2019年6月泰安市中心医院消化内科诊断为胃早癌并接受ESD治疗的98例患者为研究对象,根据EUS结果将患者分为富血管组(R组,38例)和非富血管组(P组,60例)。记录两组ESD术后的血红蛋白(HB)下降率、ESD操作时间、和谐夹的使用率及肌层损伤的发生率。结果两组HB下降率无显著差异(P>0.05);R组ESD操作时间显著长于P组(P<0.05),和谐夹使用率、肌层损伤发生率明显高于P组(P<0.05)。结论EUS可以预测ESD的操作时间、肌层损伤率及钛夹的使用情况。因此,EUS可以用来预测ESD操作的安全性。

Objective To analyze the value of high frequency small probe endoscopic ultrasonography(EUS)in evaluating safety of the endoscopic submucosal dissection(ESD)before operation.Methods From January 2017 to June 2019,98 patients with early gastric cancer diagnosed by gastroenterology department of Taian city central hospital and treated with ESD were selected as the study objects.According to the results of EUS,the patients were divided into vascular rich group(R group,38 cases)and non vascular rich group(P group,60 cases).The decrease rate of hemoglobin(HB)after ESD,ESD operation time,the usage rate of harmonic clamp and the incidence of myometrial injury between the two groups were recorded.Results There was no significant difference in the decrease rate of HB between the two groups(P>0.05);ESD operation time in the group R was significantly longer than that in the group P(P<0.05),the use rate of harmonic clamp and the incidence of myometrial injury were significantly higher than those in the group P(P<0.05).Conclusion EUS can predict the operating time of ESD,the rate of muscle damage,and the use of titanium clips.Therefore,EUS can be used to predict the safety of ESD operations.