内镜黏膜下剥离术和外科手术治疗胃早癌的疗效对比研究

A comparative study on the efficacy of endoscopic submucosal dissection and surgery in the treatment of early gastric cancer

目的:分析比较应用内镜黏膜下剥离术(ESD)与外科手术治疗胃早癌患者的临床效果。方法:选择2017年1月—2019年1月收治的胃早癌患者100例,根据手术方法不同分为两组,每组50例。对照组给予外科手术治疗,观察组应用内镜黏膜下剥离术治疗,比较两组治疗效果。结果:观察组术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05);观察组生活质量指数量表(QL-Index)各维度评分高于对照组,差异有统计学意义(P<0.05);观察组整体生活质量评分高于对照组,且两组患者的躯体、角色、情绪、认知以及社会功能评分比较,差异有统计学意义(P<0.05);观察组术后焦虑抑郁评分量表(HADS)中的抑郁评分和匹兹堡睡眠质量调查问卷(PSQI)评分与对照组比较,差异均有统计学意义(P<0.05);观察组3年生存率与对照组比较,差异无统计学意义(P>0.05);对照组随访期间没有出现复发,观察组随访期间复发2例(1例行外科手术后痊愈,1例行ESD治疗后痊愈)。结论:内镜黏膜下剥离术应用于胃早癌患者,能够有效减少术后并发症,改善患者身体状况和生活质量,减轻患者不良情绪,进而改善患者睡眠质量。

Objective:To analyze and compare the clinical effects of endoscopic submucosal dissection(ESD)and surgical treatment in patients with early gastric cancer.Methods:All 100 patients with early gastric cancer admitted to hospital from January 2017 to January 2019 were selected and divided into two groups.The control group was given surgical treatment,and the study group was treated with endoscopic submucosal dissection,and the therapeutic effects of the two groups were compared.Results:The incidence of postoperative perforation,bleeding and fever in the study group was significantly lower than the control group,with a significant difference(P<0.05).The quality of life index score(QL-Index)of the study group was higher than that of the control group,and there were significant differences in physical function,role function,emotional,cognitive and social function scores between the two groups(P<0.05).The depression score of hospital anxiety and depression scales(HADS)score and Pittsburgh sleep quality index(PSQI)score in the study group were significantly different from the control group(P<0.05).Compared with the control group,the 3-year survival rate of the observation group was not statistically significant(P>0.05).There was no recurrence during the follow-up period in the control group.Two cases relapsed during the follow-up period in the observation group,one case recovered after surgery and one case recovered after ESD treatment.Conclusion:The application of endoscopic submucosal dissection in patients with early gastric cancer can effectively reduce postoperative complications,improve the patient′s physical condition and quality of life,reduce the patient′s bad mood,and thereby improve the patient′s sleep quality.