消化内镜黏膜下剥离术治疗早期胃癌的效果观察

Observation on the Effect of Endoscopic Submucosal Dissection in the Treatment of Early Gastric Cancer

目的研究消化内镜黏膜下剥离术治疗早期胃癌的效果。方法选取福建省老年医院于2021年1月—2022年6月收治的早期胃癌患者60例,采用随机双盲法分为对照组(30例)和观察组(30例)。对照组采用消化内镜黏膜下切除术治疗,观察组采用消化内镜黏膜下剥离术治疗。结果观察组早期胃癌患者完全切除率、治愈性切除率高于对照组(χ^(2)=4.043、7.051,P<0.05)。观察组早期胃癌患者手术时间、术中出血量高于对照组(t=12.742、14.581,P<0.05),胃肠道功能恢复时间、住院时间低于对照组(t=15.320、7.297,P<0.05)。治疗后,观察组早期胃癌患者CA125、CA199低于对照组,对比结果差异有统计学意义(t=9.182、6.706,P<0.05)。治疗后,观察组早期胃癌患者胃动素、胃蛋白酶原Ⅰ高于对照组,对比结果差异有统计学意义(t=10.255、6.492,P<0.05)。观察组早期胃癌患者肠梗阻、胃穿孔、出血、感染总发生率低于对照组(χ^(2)=4.342,P<0.05)。观察组早期胃癌患者复发率(术后3个月)略低于对照组(χ^(2)=1.724,P>0.05);术后6个月复发率低于对照组(χ^(2)=4.064,P<0.05)。结论消化内镜黏膜下剥离术治疗早期胃癌的效果显著优于消化内镜黏膜下切除术治疗,因此消化内镜黏膜下剥离术治疗更具推广价值。

Objective To study the therapeutic effect of submucosal dissection of early gastric cancer under digestive endoscopy.Method Sixty patients with early gastric cancer were selected from Fujian Provincial Geriatric Hospital,with a time range of January 2021 to June 2022.The grouping method was a randomized double-blind method.The control group consisted of 30 cases treated with submucosal resection under digestive endoscopy,while the observation group consisted of 30 cases treated with submucosal dissection under digestive endoscopy.Results The complete resection rate and curative resection rate of early gastric cancer patients in the observation group were higher than those in the control group(χ^(2)=4.043,7.051,P<0.05).The surgical time and intraoperative blood output of early gastric cancer patients in the observation group were higher than those in the control group(t=12.742,14.581,P<0.05),while the recovery time and hospitalization time of gastrointestinal function were lower than those in the control group(t=15.320,7.297,P<0.05).After treatment of early gastric cancer patients,the levels of CA125 and CA199 in the observation group were lower than those in the control group(t=9.182,6.706,P<0.05);the levels of motilin and pepsinogen I were higher in the control group(t=10.55,6.492,P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group(χ^(2)=4.342,P<0.05).The recurrence rate of early gastric cancer patients in the observation group(3 months after surgery)was slightly lower than that in the control group(χ^(2)=1.724,P>0.05);the recurrence rate(6 months after surgery)was significantly lower than that of the control group(χ^(2)=4.064,P<0.05).Conclusion Early gastric cancer patients are treated with endoscopic submucosal dissection,which has a significantly better therapeutic effect than endoscopic submucosal resection.It can be seen that endoscopic submucosal dissection has significant advantages and more promotional value.