内镜黏膜下剥离术治疗消化道肿瘤的临床效果

Clinical effect of endoscopic submucosal dissection in the treatment of gastrointestinal tumors

目的探究内镜黏膜下剥离术(ESD)治疗消化道肿瘤的有效性和安全性。方法204例消化道肿瘤患者,依据随机数字表法分为观察组和对照组,每组102例。对照组行内镜下黏膜切除术(EMR)治疗,观察组行ESD治疗,比较两组病灶整块切除率、治愈性切除率、横向切缘阴性率、纵向切缘阴性率、手术时间、并发症发生率。结果观察组病灶整块切除率91.18%、治愈性切除率82.35%、横向切缘阴性率92.16%、纵向切缘阴性率90.20%均高于对照组的55.88%、52.94%、70.59%、64.71%,差异均具有统计学意义(P<0.05)。观察组手术时间(36.22±7.35)min短于对照组的(71.29±12.46)min,差异具有统计学意义(t=24.484,P<0.05)。观察组并发症发生率3.92%低于对照组的11.76%,差异有统计学意义(P<0.05)。结论ESD治疗消化道肿瘤的临床效果显著,可有效缩短手术时间,利于患者术后康复,且术后并发症少,治疗安全性高,值得在临床上推广应用。

Objective To investigate the effectiveness and safety of endoscopic submucosal dissection(ESD)in the treatment of gastrointestinal tumors.Methods A total of 204 patients with gastrointestinal tumors were divided into observation group and control group according to the random numerical table,with 102 cases in each group.The control group was treated with endoscopic mucosal resection(EMR),and the observation group was treated with ESD.The whole lesion resection rate,curative resection rate,transverse margin negative rate,longitudinal margin negative rate,operation time and complication rate were compared between the two groups.Results The whole lesion resection rate,curative resection rate,transverse margin negative rate,longitudinal margin negative rate of the observation group were 91.18%,82.35%,92.16%,and 90.20%,which were higher than 55.88%,52.94%,70.59%,and 64.71% of the control group,and the differences were statistically significant(P<0.05).The operation time(36.22±7.35)min of the observation group was shorter than(71.29±12.46)min of the control group,and the difference was statistically significant(t=24.484,P<0.05).The complication rate 3.92% of the observation group was lower than 11.76% of the control group,and the difference was statistically significant(P<0.05).Conclusion ESD has significant clinical effect on gastrointestinal tumors,which can effectively shorten the operation time,and is conducive to the postoperative rehabilitation of patients.It has less postoperative complications and high safety,and is worthy of clinical promotion and application.