无痛ESD在早期胃癌治疗中的应用

目的总结无痛内镜黏膜下剥离术(ESD)治疗早期胃癌的手术经验,以提高ESD的成功率并减少手术并发症的发生。方法将50例经胃镜及病理确诊为早期胃癌并采用ESD行病变切除治疗的患者随机分为局麻组、全麻组,每组25例。局麻组行表面麻醉并鼻导管吸氧,全麻组行表面麻醉联合气管插管全麻。监测患者ECG、HR、SPO2、MAP,术后对ESD操作情况和患者术中疼痛进行评价。结果局麻组术中MAP、HR均高于其基础值,也高于全麻组(P<0.05);全麻组患者ESD操作评分、镇痛效果均优于局麻组(P<0.05)。结论表面麻醉联合气管插管全麻较单纯表面麻醉下进行ESD更安全有效,且并发症更少。

Application of Painless ESD in Early Gastric Cancer

Objective To observe the surgery experience of painless endoscopic submucosal dissection(ESD) in the treatment of early gastric cancer,and to improve the achievement ratio of ESD and reduce the complications.Methods The 50 patients with early gastric cancer were randomly divided into two groups: the local anesthetic group(25 patients) and the general anesthetic group(25 patients).The patients in the local anesthetic group received the surface anesthesia and oxygen inhalation via nasal tube;the patients in the general anesthetic group received the surface anesthesia and general anesthesia with tracheal intubation.The ECG,MAP,HR,SpO2 and MAP were observed;and the ESD operation and the pain scores of the patients were calculated.Results The MAP,HR of the patients in the local anesthetic group were higher than the base values and those of the general anesthetic group(P<0.05).The ESD operation and pain scores of the general anesthetic group were better than those of the local anesthetic group(P<0.05).Conclusion Under the surface anesthesia combined with general anesthesia with tracheal intubation,ESD is safe and effective.