上消化道早癌与癌前病变内镜下治疗的效果评价

doi:10.3969/j.issn.1000-8535.2021.05.016

摘要/Abstract

摘要： 目的分析上消化道早癌与癌前病变内镜下治疗的效果。方法将2017年10月—2020年10月接诊且行传统外科手术治疗的75例上消化道早癌与癌前病变患者作为对照组,将同期接诊且行内镜黏膜下剥离术(ESD)治疗的75例上消化道早癌与癌前病变患者作为观察组,对组间围手术期指标、生活质量、疼痛评分、病灶切除情况、治疗效果、并发症发生率展开分析。结果 (1)观察组术中出血量(17.66±2.25)mL、手术用时(96.79±9.25)min、住院时间(10.95±1.88)d、治疗费用(1.74±0.41)万元均少于对照组(87.73±5.63)mL、(190.52±10.68)min、(22.75±2.69)d、(4.96±0.37)万元(P<0.05);(2)组间生活质量、疼痛评分在术前无差异(P>0.05);观察组生活质量、疼痛评分在术后优于对照组(P<0.05);(3)观察组治愈性切除率(98.67%)、整块完整切除率(100.00%)与对照组(96.00%、98.67%)无差异(P>0.05);(4)观察组总有效率(96.00%)与对照组(97.33%)无明显差异(P>0.05);(5)观察组发生2例并发症(2.67%),对照组发生11例并发症(14.67%,P<0.05)。结论对上消化道早癌与癌前病变患者行ESD治疗,疗效显著,可以减少并发症,减轻疼痛感与经济压力,改善生活质量,值得推广。

关键词: 消化道早癌, 癌前病变, 内镜, 治疗效果

Abstract: Objective To analyze the effect of endoscopic treatment of early upper gastrointestinal cancer and precancerous lesions. Methods From October 2017 to October 2020, 75 patients with early cancer and precancerous lesions of upper digestive tract who were treated by traditional surgery were selected as the control group, and 75 patients with early cancer and precancerous lesions of upper digestive tract who were treated by endoscopic submucosal dissection (ESD) were selected as the observation group. The therapeutic effect and the incidence of complications were analyzed. Results (1) The intraoperative blood loss was (17.66±2.25) mL, operation time was (96.79±9.25) min, hospitalization time was (10.95±1.88) d, treatment cost was(17.4±4.1)thousand yuan in the observation group, which were less than those in the control group [(87.73±5.63) mL, (190.52±10.68) min, (22.75±2.69) d, (49.6±3.7) thousand yuan, (P＜0.05)]. (2) There were no significant differences in quality of life and pain score between groups before operation. The quality of life and pain score of the observation group were better than those of the control group after operation (P<0.05). (3) The curative resection rate (98.67%) and complete resection rate (100.00%) of the observation group were not significantly different from those of the control group (96.00% and 98.67%,P＞0.05); (4) The total effective rate (96.00%) of the observation group was not significantly different from that of the control group (97.33%,P＞0.05); (5) The total effective rate of the observation group was significantly higher than that of the control group (97.33%). There were 2 cases of complications in the observation group (2.67%), and 11 cases in the control group (14.67%, P<0.05). Conclusion ESD treatment for patients with early upper gastrointestinal cancer and precancerous lesions has significant effect, can reduce complications, relieve pain and economic stress, and improve the quality of life, which is worthy of promotion.

Key words: early gastrointestinal cancer, precancerous lesions, endoscopy, therapeutic effect

杨少宾, 张丽, 李俊娜. 上消化道早癌与癌前病变内镜下治疗的效果评价[J]. 广州医药, 2021, 52(5): 76-79.

YANG Shaobin, ZHANG Li, LI Junna. Evaluation of endoscopic treatment for early upper gastrointestinal cancer and precancerous lesions[J]. Guangzhou Medical Journal, 2021, 52(5): 76-79.

参考文献

[1] 薛成俊,沈阳,尤国莉,等.ESD治疗老年消化道早癌的效果及对患者生存质量的影响[J].中国实用医药,2020,15(33):4-6.
[2] 靳迎春,赵金,周津.上消化道早期癌癌前病变患者应用内镜下黏膜剥离术治疗的效果观察[J].河北医学,2020,26(8):1338-1343.
[3] 王桢桢,邓奇烽,麦国,等.内镜黏膜下剥离术与传统外科手术在消化道早癌或癌前病变患者中的应用效果[J].中外医学研究,2020,18(19):16-18.
[4] 周杨芳.内镜黏膜下剥离术治疗消化道早期癌和癌前病变的疗效分析[J].中国医刊,2020,55(5):555-558.
[5] 陈用军,唐尚军.用内镜下黏膜剥离术对消化道早癌患者进行治疗的效果研究[J].当代医药论丛,2020,18(9):103-104.
[6] 张艳,毕小刚,黄纯秀,等.探讨黏膜下剥离术与黏膜切除术在上消化道早癌及癌前病变中的应用[J].现代消化及介入诊疗,2020,25(3):404-406.
[7] 李云,夏秀丽,徐超,等.内镜下经多隧道黏膜下剥离术和内镜黏膜下剥离术治疗消化道早癌及癌前病变的疗效及安全性[J].中国老年学杂志,2020,40(3):505-508.
[8] 刘卫华.内镜下黏膜剥离术与内镜黏膜切除术治疗上消化道早期癌及癌前病变的临床研究[J].中国疗养医学,2019,28(12):1301-1303.
[9] 刘剑雄.内镜黏膜下剥离术治疗消化道早癌患者的疗效[J].医疗装备,2019,32(23):100-101.
[10] 吴贺华,董俊,张鸣青,等.ESD治疗消化道早癌及癌前病变的临床疗效及对患者生活质量的影响[J].现代消化及介入诊疗,2019,24(9):996-998.
[11] 林素丽.内镜下黏膜剥离术与内镜黏膜切除术治疗上消化道早期癌及癌前病变研究[J].齐齐哈尔医学院学报,2019,40(16):2056-2057.
[12] 丁莹红,毛晓阳,陈月丽,等.内镜黏膜下剥离术和外科手术治疗消化道早癌及癌前病变的比较观察[J].中国现代药物应用,2019,13(8):41-43.
[13] 张晓兰.内镜黏膜下剥离术和外科手术治疗消化道早癌及癌前病变的临床对比研究[J].实用医技杂志,2019,26(3):321-322.
[14] 何咖鲒,韦树理,谭丽,等.内镜窄带成像技术用于消化道早癌及癌前病变的筛查及临床评价[J].现代消化及介入诊疗,2020,25(7):964-966.
[15] 周杨芳.内镜黏膜下剥离术治疗消化道早期癌和癌前病变的疗效分析[J].中国医刊,2020,55(5):555-558.