内镜黏膜下剥离术联合预荷包缝合对早期上消化道肿瘤的病灶清除率、胃肠功能及并发症的影响

目的:内镜黏膜下剥离术联合预荷包缝合对早期上消化道肿瘤的病灶清除率、胃肠功能及并发症的影响。方法:选取2016年3月至2018年6月在本院住院并接受治疗的早期上消化道肿瘤患者70例作为研究对象，并采用随机数字表法将患者随机分为研究组和对照组，每组各35例。对照组仅进行内镜黏膜下剥离术治疗，研究组进行内镜黏膜下剥离术联合预荷包缝合治疗。观察治疗后患者病灶清除率、胃肠功能、并发症发生情况、临床疗效及患者治疗后复发情况。结果:治疗后，研究组患者病灶清除率显著高于对照组（P＜0.05）；研究组患者肛门排气时间及排便时间均显著低于对照组（P＜0.05）；研究组患者出血、消化道狭窄及穿孔率均低于对照组，且总并发症发生率显著低于对照组（P＜0.05）；研究组患者的总有效率明显高于对照组（P＜0.05）；治疗后随访半年及一年，研究组患者肿瘤复发率均显著低于对照组（P＜0.05）。结论:内镜黏膜下剥离术联合预荷包缝合治疗较单独使用内镜黏膜下剥离术治疗在提高早期上消化道肿瘤的病灶清除率和胃肠功能及减少并发症方面更有优势，且安全性较高。

The effects of endoscopic submucosal dissection combined with pre-purse-string suture on the lesion clearance rate,gastrointestinal function and complications in patients with early tumor of upper digestive tract

Objective:To investigate the effects of endoscopic submucosal dissection combined with pre-purse-string suture on the lesion clearance rate,gastrointestinal function and complications in patients with early tumor of upper digestive tract.Methods:From March 2016 to June 2018,70 patients with early tumors of the upper digestive tract who were hospitalized and treated in our hospital were selected as the study objects,and the patients were randomly divided into the study group and the control group,with 35 cases in each group.The control group was only treated by endoscopic submucosal dissection,while the study group was treated by endoscopic submucosal dissection combined with pre-purse-string suture.After treatment,the lesion clearance rate,gastrointestinal function,complications,clinical effect and recurrence were observed.Results:After treatment,the lesion clearance rate of the study group was significantly higher than that of the control group(P<0.05).After treatment,the anal exhaust time and defecation time in the study group were significantly lower than those in the control group(P<0.05).After treatment,the incidence rates of bleeding,gastrointestinal stenosis and perforation in the study group were lower than those in the control group,and the incidence rate of total complications was significantly lower than that in the control group(P<0.05).After treatment,the total effective rate of the study group was significantly higher than that of the control group(P<0.05),and after half a year and one year of follow-up,the recurrence rates in the study group were significantly lower than those in the control group(P<0.05).Conclusion:Endoscopic submucosal dissection combined with pre-purse-string suture is superior to endoscopic submucosal dissection alone in improving the clearance rate of lesions,gastrointestinal function and reducing complications in patients with early tumor of upper digestive tract.