内镜黏膜下剥离术治疗早期胃癌的效果研究

目的探讨内镜黏膜下剥离术(ESD)治疗早期胃癌的安全性和有效性。方法根据手术方式不同将98例早期胃癌患者分为对照组与观察组,每组49例。对照组采用外科手术治疗,观察组采用ESD治疗,比较两组患者手术一般情况、肿瘤整块切除率和治愈性切除率以及术后并发症发生情况。观察两组术前、术后7天血浆中肠道功能指标(D-乳酸、二胺氧化酶)水平变化和1年内复发情况。结果观察组患者手术时间和术后住院时间均明显短于对照组,两组比较差异均有统计学意义(P﹤0.01)。两组患者肿瘤整块切除率、治愈性切除率比较,差异均无统计学意义(P﹥0.05)。两组患者1年内复发率比较,差异无统计学意义(P﹥0.05)。两组并发症总发生率比较,差异有统计学意义(P﹤0.05)。术前,两组患者D-乳酸、二胺氧化酶水平比较,差异均无统计学意义(P﹥0.05);术后7天,观察组D-乳酸、二胺氧化酶水平均低于对照组(P﹤0.05)。结论ESD治疗早期胃癌效果较好,安全性较高,能够减少患者手术时间、住院时间以及并发症的发生,促进患者康复。

Study on the effect of endoscopic submucosal dissection in treating early gastric cancer

Objective To investigate the safety and effect of endoscopic submucosal dissection(ESD)in treating early gastric cancer.Method A total of 98 patients with early gastric cancer were selected,they were divided into the control group and observation group according to different operation regimens,49 cases in each group.The control group was treated with surgery,and the observation group was treated with ESD.The general condition of the procedure,the resection of residual masses,the curative resection rate,and the incidence of postoperative complications between the two groups were compared.The alternations in plasma levels of intestinal function indexes(D-lactic acid,diamine oxidase)and recurrence within 1 year were observed in the two groups before and 7 days after the operation.Result The operation time and postoperative hospitalization time in observation group were significantly shorter than those in control group,the differences between the two groups were statistically significant(P<0.01).There was no significant difference in the tumor resection rate and curative resection rate between the two groups(P>0.05).There was no significant difference in the cancer recurrence rate within 1 year between the two groups of patients(P>0.05).There was a statistically significant difference in the total incidence of complications between the two groups(P<0.05).Before surgery,the differences in the levels of D-lactic acid and diamine oxidase between the two groups of patients were not statistically significant(P>0.05);7 days after surgery,the levels of D-lactic acid and diamine oxidase in the observation group were significantly lower than those in the control group(P<0.05).Conclusion ESD treatment on early gastric cancer has a good effect and reliable safety.It can shorter the operation time,hospitalization time,decrease the risk of complications,and promote patients’recovery.