超声内镜辅助下ESD治疗上消化道隆起性病变的疗效

Efficacy of Endoscopic Ultrasonography-assisted ESD in the Treatment of Elevated Lesions of the Upper Gastrointestinal Tract

目的分析上消化道隆起性病变患者采取超声内镜辅助下内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗的效果。方法研究选取52例2018年2月—2021年10月在徐州市肿瘤医院接受治疗的上消化道隆起性病变患者为研究对象,依据信封随机法分为对照组(26例,采用超声内镜辅助下黏膜切除术治疗)和观察组(26例,采用超声内镜辅助下ESD治疗)。对比两种治疗方式的治疗效果、围术期指标及并发症发生率。结果两组治疗有效率分别为96.15%、80.77%,差异无统计学意义(χ^(2)=1.696,P>0.05);观察组手术时间(35.63±7.25)min、术中失血量(95.18±18.76)mL、术后下床时间(2.50±0.42)d、恢复进食时间(2.45±0.67)d、住院时间(7.25±1.75)d均短于/低于对照组的(59.46±8.77)min、(124.55±25.34)mL、(3.85±0.76)d、(3.86±0.75)d、(9.86±1.77)d,差异有统计学意义(t=10.679、4.750、7.927、7.149、5.347,P<0.05);观察组并发症发生率(3.85%)低于对照组(30.77%),差异有统计学意义(χ^(2)=4.837,P<0.05)。结论在上消化道隆起性病变治疗中采取超声内镜辅助下ESD干预效果显著,可有效减少患者术中失血量,减少并发症,促进其预后恢复。

Objective To analyze the effect of endoscopic ultrasonography-assisted endoscopic submucosal dissection(ESD)in patients with upper gastrointestinal bulge lesions.Methods The study selected 52 patients with upper gastrointestinal bulging lesions who were treated in Xuzhou Cancer Hospital from February 2018 to October 2021 as the research objects.According to the envelope random method,they were divided into control group(26 cases,treated with endoscopic ultrasonography-assisted mucosal resection)and observation group(26 cases,treated with endoscopic ultrasonography-assisted ESD).The therapeutic effects,perioperative indicators and complication rates of the two treatment methods were compared.Results The effective rates of the two groups were 96.15%and 80.77%,respectively,and the difference was not statistically significant(χ^(2)=1.696,P>0.05).The operation time of the observation group(35.63±7.25)min,the intraoperative blood loss(95.18±18.76)mL,the postoperative time to get out of bed(2.50±0.42)d,the time to resume eating(2.45±0.67)d,and the hospitalization time(7.25±1.75)d were shorter/lower than the control group(59.46±8.77)min,(124.55±25.34)mL,(3.85±0.76)d,(3.86±0.75)d,(9.86±1.77)d,and the difference was statistically significant(t=10.679,4.750,7.927,7.149,5.347,P<0.05).The incidence of complications in the observation group(3.85%)was lower than that in the control group(30.77%),and the difference was statistically significant(χ^(2)=4.837,P<0.05).Conclusion The effect of endoscopic ultrasonography-assisted ESD intervention in the treatment of upper gastrointestinal bulge lesions is significant,which can effectively reduce the intraoperative blood loss,reduce complications,and promote the recovery of their prognosis.