ESD与传统手术治疗消化道早癌及癌前病变的有效性、安全性及费效比对比观察

目的：分析比较ESD与传统手术治疗消化道早癌及癌前病变的有效性﹑安全性及费效比。方法方便选取2014年10月—2015年10月该院住院部收治的消化道早癌及癌前病变患者60例，按照随机数字表法分为研究组与对照组，两组各为30例，研究组采用内镜粘膜下剥离术(ESD)，对照组采用传统外科手术，观察两组患者的住院费用﹑手术时间﹑住院天数及并发症等不良反应。结果两组患者的手术时间﹑住院时间及治疗费用的比较，差异具有统计学意义(P<0.05)，研究组患者的病变处完全切除率为86.67%(26/30)，对照组患者的病变处完全切除率为93.33%(28/30)，两组患者病变处完全切除率比较，差异无统计学意义(P>0.05)，两组患者的出血﹑食管反流﹑感染并发症发生率比较，差异具有统计学意义(P<0.05)。结论内镜粘膜下剥离术较传统手术治疗消化道早癌及癌前病变安全有效，一定程度降低患者的经济负担，具有创伤小﹑康复快，值得在临床上大力推广应用。

The Comparative Study of Safety and Cost-effectiveness of ESD with Tradi-tional Surgery Early Treatment of Gastrointestinal Cancer and Precancerous Lesions

Objective To compare the effectiveness of ESD and traditional surgical treatment of gastrointestinal cancer and the early precancerous lesions, safety and cost-effectiveness. Methods Convenient selection from October 2014 to October 2015 in our hospital early gastrointestinal cancer and precancerous lesions in 60 patients, randomly divided according to the study group and the control group, two groups of 30 cases, the study group adopted endoscopic submucosal dissection (ESD), the control group using traditional surgery, hospitalization costs observed two groups of patients, operative time, length of stay and complications and other adverse reactions. Results There were operative time, length of stay and cost of treatment, the difference was statistically significant (P<0.05),the study group of patients with complete resection rate was 86.67%(26/30), the control group of patients was 93.33%(28/30), the difference was statistically significant (P>0.05), two groups of patients with bleeding, esophageal reflux, the incidence of infectious complications The difference was statistically signifi-cant (P<0.05). Conclusion Endoscopic submucosal dissection security than traditional surgical treatment of gastrointestinal cancer and precancerous lesions early and effective, to some extent reduce the financial burden of patients, with less trauma and faster recovery, to promote worthy of clinical application.