双钳道内镜治疗贲门-胃底部黏膜下肿瘤的临床效果

Clinical effect of double clamp endoscopy in the treatment of submucosal tumors of cardia and gastric fundus

目的探讨双钳道内镜治疗贲门-胃底部黏膜下肿瘤的临床效果。方法选取2017年1月至2019年12月本院收治的95例贲门-胃底部黏膜下肿瘤患者,依据手术方法将其分为常规性内镜组(n=45,常规性内镜下黏膜剜除术)和双钳道内镜组(n=50,双钳道内镜下黏膜剥离术)。比较两组的手术相关指标、术后并发症发生情况及手术前、后的BDI-Ⅱ、IADL及SF-36评分。结果双钳道内镜组患者的手术时间、住院时间短于常规性内镜组,术中出血量少于常规性内镜组,住院费用低于常规性内镜组(P<0.05)。双钳道内镜组的并发症总发生率为6.0%,低于常规性内镜组的26.7%(P<0.05)。手术后,两组患者的BDI-Ⅱ及IADL评分均降低,SF-36评分均升高,且双钳道内镜组优于常规性内镜组(P<0.05)。结论应用双钳道内镜治疗贲门-胃底部黏膜下肿瘤可减少患者术中出血量,缩短手术时间,减少住院费用,降低并发症发生率,促进患者康复。

Objective To investigate the clinical effect of double clamp endoscopy in the treatment of submucosal tumors of cardia and gastric fundus.Methods Ninety-five patients with submucosal tumor of cardia and gastric fundus admitted in our hospital from January 2017 to December 2019 were selected and divided into conventional endoscopy group(n=45,conventional endoscopic mucosal enucleation)and double clamp endoscopy group(n=50,double clamp endoscopic mucosal dissection)according to the operation method.The operation related indexes,postoperative complications,the scores of BDI-Ⅱ,IADL and SF-36 before and after operation were compared between the two groups.Results The operation time and hospital stay of the double clamp endoscopy group were shorter than those of the conventional endoscopy group,the intraoperative blood loss volume was less than that of the conventional endoscopy group,and the hospitalization cost was lower than that of the conventional endoscopy group(P<0.05).The total incidence of complications in the double clamp endoscopy group was 6.0%,which was lower than 26.7%in the conventional endoscopy group(P<0.05).After operation,the scores of BDI-Ⅱand IADL of the two groups decreased,SF-36 scores increased,and those of the double clamp endoscopy group were better than the conventional endoscopy group(P<0.05).Conclusion The application of double clamp endoscopy in the treatment of submucosal tumor of cardia and gastric fundus can reduce the intraoperative blood loss volume,shorten the operation time,reduce hospitalization cost and the incidence of complications,and promote the rehabilitation of patients.