内镜黏膜下剥离术治疗消化系统早癌及癌前病变的临床疗效观察

Clinical Efficacy Observation of Endoscopic Submucosal Dissection in Treatment of Early Cancer and Precancerous Lesions of Digestive System

目的:探讨对消化系统早癌及癌前病变应用内镜黏膜下剥离术治疗的临床效果。方法:将2019年1月-2020年12月东莞市人民医院红楼院区经临床诊断确诊为消化系统早癌及癌前病变患者219例作为研究对象,以平行信封抽签方式分为对照组(109例)与试验组(110例)。试验组采用内镜黏膜下剥离术治疗,对照组采用传统手术治疗。比较两组治疗效果。结果:试验组手术时间、术后首次下床活动时间均显著短于对照组,术中出血量及术后发生出血、胃食管反流、食管狭窄的并发症发生率均显著低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后肿瘤标志物[癌胚抗原(CEA)、糖类抗原199(CA199)]水平均低于本组治疗前(P<0.05),但两组治疗后CEA、CA199水平比较差异无统计学意义(P>0.05)。结论:对消化系统早癌及癌前病变采用内镜黏膜下剥离术进行治疗,可有效优化手术指标,降低并发症发生率,改善肿瘤标志物水平,治疗效果显著。

Objective:To explore the clinical effect of endoscopic submucosal dissection in the treatment of early cancer and precancerous lesions of digestive system.Methods:A total of 219 patients with early cancer and precancerous lesions of digestive system confirmed by clinical diagnosis in Honglou District,Dongguan People’s Hospital from January 2019 to December 2020 were enrolled as the study subjects.They were divided into control group(n=109)and experimental group(n=110)according to parallel envelope sortation method.The experimental group was treated by endoscopic submucosal dissection and the control group was treated with traditional surgery.The therapeutic effects were compared between two groups.Results:The operation time and the first ambulation time after operation in the experimental group were significantly shorter than those in the control group,the intraoperative blood loss and the incidence of postoperative complications of bleeding,gastroesophageal reflux and esophageal stenosis in the experimental group were significantly lower than those in the control group,with significant differences(P<0.05).The levels of tumor markers[carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)]in the two groups after treatment were lower than that before treatment in the same group(P<0.05),but there was no statistically significant difference in CEA and CA199 levels between two groups after treatment(P>0.05).Conclusion:Endoscopic submucosal dissection for early cancer and precancerous lesions of digestive system can effectively optimize the operation indexes,reduce the probability of complications,improve the levels of tumor markers and show significant treatment effect.