综述

儿童孤立性直肠溃疡综合征的诊治进展

Advances in the diagnosis and treatment of isolated rectal ulcer syndrome in children

:1175-1181
 
        儿童孤立性直肠溃疡综合征(SRUS)是一种较为罕见的慢性直肠疾病,儿童发病率低且缺乏明确统计学数据。该病主要表现为便血、排黏液便和排便不尽感,临床诊断较为困难,常易误诊为其他疾病。其发病机制尚不明确,可能与排便习惯异常、直肠黏膜异常、血管异常以及遗传易感性等多种因素有关,其中 CHEK2 基因的 p.H371Y 突变可能在发病机制中起关键作用。诊断需综合病史、体格检查以及排粪造影、超声内镜、肠镜检查与组织病理活检等多种辅助检查手段。治疗上目前尚无统一指南,主要包括改善饮食和排便习惯、生物反馈治疗、药物治疗、内镜下治疗和外科手术治疗等,但总体治疗难度较大且复发率较高。本文对儿童 SRUS 的流行病学、发病机制、临床表现、诊断和治疗等方面的研究进展进行综述,旨在提高临床医师对该病的诊疗水平,为未来进一步的研究提供参考依据。
       Solitary rectal ulcer syndrome(SRUS)in children is a chronic and benign disease of the rectum characterized by ulcers. The clinical incidence of SRUS in children is not high, but it is prone to misdiagnose and miss diagnosis,which can delay the optimal treatment opportunity. This article reviews the research progress on the epidemiology,pathogenesis, clinical manifestations, diagnosis and treatment of SRUS in children, aiming to improve the diagnostic and therapeutic level of clinicians.
论著

鲁拉西酮治疗女性急性期精神分裂症的疗效及代谢风险观察

Observation of the efficacy and metabolic risk of lurasidone in the treatment of acute schizophrenia in women

:1145-1152
 
        目的   比较鲁拉西酮与奥氮平用于治疗女性急性期精神分裂症患者的疗效,以及其对体质量、糖脂代谢风险的影响。以期为女性急性期的精神分裂症患者抗精神病药物的选择提供参考。方法   连续选取于2022年4月—2024年4月内江门市第三人民医院收治的女性急性期精神分裂症患者80例,采用计算机随机分组法将患者分为治疗组与阳性药物对照组进行对照。治疗组40例口服鲁拉西酮40~80 mg/d,阳性药物对照40例组口服奥氮平5~20 mg/d。分别测量两组治疗前(基线)以及连续用药治疗2、4、6周后的PANSS量表评分,以及治疗后的代谢指标[体质量指数(BMI)、血清空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、载脂蛋白E(ApoE),并将治疗组与对照组前后疗效及各项代谢指标进行比较分析。结果   两组的总有效率比较差异无统计学意义(χ 2 =1.569,P>0.05);两组治疗前后PANSS量表评分的时间-组别效应与组别效应均无统计学意义(χ 2 =0.466、3.640,P=0.926、0.056),时间主效应显著(χ 2 =363.24,P<0.001)。两组TG、TC、HDL、ApoA、ApoB存在组别-时间交互效应(χ 2 =7.562、5.991、6.163、6.958、4.397,P=0.006、0.014、0.013、0.008、0.036),两组TG、ApoA时间主效应显著(χ 2 =33.473、8.846,P<0.001、0.003),两组ApoA组别效应显著(χ 2 =4.889,P=0.027)。   与奥氮平相比,鲁拉西酮治疗女性急性期精神分裂症的疗效相当,且对代谢指标影响更小。
        Objective  To compare the efficacy of lurasidone and olanzapine in the treatment of female patients with acute schizophrenia,as well as their effects on body mass,glucose and lipid metabolism risk.To provide  reference for the selection of antipsychotic drugs for female patients with acute schizophrenia.Methods  From April 2022 to April 2024,80 female patients with acute phase schizophrenia admitted to the Third People’s Hospital of Jiangmen City were selected as samples and included in the study.The patients were randomly divided into a treatment group and a positive drug control group using a computer randomization method for comparison.The treatment group took oral lorazepine tablets(40 cases;40-80 mg/d),while the positive drug control group took oral olanzapine tablets(40 cases;5-20 mg/d).The Positive and Negative Symptom Scale(PANSS)scores of two groups before treatment(baseline)and after 2,4,and 6 weeks of continuous medication treatment were measured,as well as metabolic indicators after treatment (body mass index[BMI],serum fasting blood glucose[FPG],total cholesterol[TC],triglycerides[TG],high-density lipoprotein[HDL],low-density lipoprotein[LDL],apolipoprotein A[ApoA],apolipoprotein B[ApoB],apolipoprotein E[ApoE]),and the efficacy and various metabolic indicators between the treatment group and the control group before and after treatment were compared and analyzed.Results  The total effective  rate of the two groups was not statistically significant(χ 2 =1.569,P>0.05).The time-group effect and group effect of PANSS scores before and after treatment in both groups were not statistically significant(χ 2 =0.466,3.640,P=0.926,0.056),while the time main effect was significant(χ 2 =363.24,P<0.001).There was a group-time interaction effect between two groups of TG,TC,HDL,ApoA,and ApoB(χ 2 =7.562,5.991,6.163,6.958,4.397,P=0.006,0.014,0.013,0.008,0.036).The time main effect of TG and ApoA was significant in both groups(χ 2 =33.473,8.846,P<0.001,0.003),and the group effect of ApoA was significant in both groups(χ 2 =4.889,P=0.027).Conclusions  Compared with olanzapine,the efficacy of lurasidone in the treatment of acute phase schizophrenia in women is comparable,and it has a smaller impact on metabolic indicators.
论著

无托槽隐形矫治对正畸拔牙患者牙根吸收、可溶性细胞间黏附分子 -1 的影响

The effect of clear aligner treatment on root resorption and soluble intercellular adhesion molecule-1 in orthodontic patients with extraction

:1122-1127
 
       目的   评估无托槽隐形矫治应用在正畸拔牙患者中的效果及对牙根吸收、可溶性细胞间黏附分子-1(sICAM-1)的影响。方法   纳入2022年1月—2024年8月的70例正畸拔牙患者,按照治疗方法分组,即对照组(35例,给予固定矫治)、观察组(35例,给予无托槽隐形矫治),评价组间牙根吸收情况、牙周指标、炎症因子、矫治时间。果   治疗结束时,两组均出现牙根吸收情况,但是观察组无牙根吸收>3 mm病例,而对照组存在牙根吸收>3 mm、>4 mm病例,P<0.05。治疗前,两组牙周指标[龈沟出血指数(SBI)、牙龈指数(GI)、菌斑指数(PLI)]、炎症因子[白介素-1β(IL-1β)、sICAM-1]比较差异无统计学意义(P>0.05)。治疗后,两组SBI、GI、PLI、IL-1β、sICAM-1升高,且观察组SBI、GI、PLI、IL-1β、sICAM-1低于对照组(P<0.05)。与对照组比较,观察组矫治时间更长(P<0.05)。结论   对正畸拔牙患者进行无托槽隐形矫治,虽然治疗时间长,但是可以抑制牙根吸收,减轻炎症反应,提高牙周健康水平。
       Objective  To evaluate the effect of clear aligner treatment on orthodontic tooth extraction patients and its impact on root resorption and soluble intercellular adhesion molecule-1(sICAM-1).Methods  Seventy orthodontic extraction patients from January 2022 to August 2024 were included and divided into two groups according to treatment methods:a control group(35 cases,receiving fixed orthodontic treatment)and an observation group(35 cases,receiving clear aligner treatment).The root resorption,periodontal indicators,inflammatory factors,and orthodontic treatment time between groups were evaluated.Results  At the end of treatment,both groups showed root resorption,but there were no cases of root resorption>3 mm in the observation group,while there were cases of root resorption>3 mm and>4 mm in the control group,P<0.05.Before treatment,there was no difference in periodontal indicators(gingival bleeding index[SBI],gingival index[GI],plaque index[PLI]),inflammatory factors(interleukin-1 β[IL-1 β],sICAM-1) between the groups,P>0.05.After treatment,SBI,GI,PLI,IL-1 β,sICAM-1 increased in both groups,but SBI,GI,PLI,IL-1 β,sICAM-1 were lower in the  observation group,P<0.05.Compared with the control group,the observation group had a longer orthodontic treatment time,P<0.05.Conclusions  Although the clear aligner treatment time for orthodontic extraction patients is longer,it can inhibit root resorption,reduce inflammatory reactions,and improve periodontal health.
论著

2005—2024 年中医药治疗小儿腺样体肥大的可视化分析

Visual analysis of traditional Chinese medicine treatment for pediatric adenoid hypertrophy from 2005 to 2024

:1045-1054
 
       目的   探讨中医药治疗小儿腺样体肥大(AH)的研究现状、研究热点及趋势,为本领域研究者提供借鉴。方法   检索中国知网(CNKI)数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量,运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果   共纳入文献395篇,年发文量整体呈现波动上升的趋势;发文量最多的作者为姜之炎;发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队;研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论  AH领域研究内容主要以内治法、外治法、作用机制为主;研究热点逐渐从临床研究转向作用机制等实验研究;应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。
       Objective  To explore the research status,research hotspots,and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children,to provide a reference for researchers in this field.Methods  The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1,2005,to January 31,2024.Excel 2019 was applied to analyze the number of published papers,and CiteSpace 6.2.R6 software was applied to analyze its authors,institutions,and keywords.Results  A total of 395 papers were included,and the annual number of papers showed a fluctuating upward trend.The author with the largest number of papers was JIANG Zhiyan.Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers.The core  research teams including JIANG Zhiyan,YU Jingmao,and YAN Zhaojun were initially formed.The  research institutions were mainly Chinese medicine colleges and their affiliated hospitals.High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods,clinical efficacy.Conclusions  The research content in this field is mainly based on internal treatment,external treatment,and mechanism.The focus has gradually shifted from clinical research to experimental research such as mechanism.The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend.
综述

可注射水凝胶药物递送系统在肿瘤治疗中的应用

The application of injectable hydrogels as drug delivery systems in tumor treatment

:1035-1044
 
       肿瘤治疗仍然是生物医学研究的一个突出领域。围绕各种化学治疗(化疗)药物和其他治疗药物的不良反应和靶向疗效的研究推动了各种药物载体的发展。这些载体聚焦于提高肿瘤部位的药物浓度,最大限度地减少全身不良反应,并改善治疗效果。在已报道的递送系统中,可注射水凝胶由于其微创的药物递送特性,已成为化疗药物体内递送的重要载体形式。文章系统地总结了可注射水凝胶的类型和特征,并进一步概括了可注射水凝胶装载药物的方式,同时深入讨论可注射水凝胶在治疗肿瘤的各种药物的递送应用。文章对原位注射水凝胶在治疗肿瘤方面存在的潜在性挑战和可能的解决方案提供了动态前瞻性的参考。可注射的水凝胶作为药物传递系统用于肿瘤治疗具有良好的发展前景。
       Tumor treatment remains a prominent area of biomedical research.The  researches surrounding the adverse 
reactions and targeted efficacy of various chemotherapy drugs and other therapeutic drugs have driven the development of various drug carriers.These carriers focus on increasing drug concentration at tumor site,minimizing systemic adverse reactions,and improving treatment outcomes.In the reported delivery systems,injectable hydrogels have become an important carrier for the delivery of chemotherapeutic drugs in vivo due to their minimally invasive characteristics.This review systematically summarized the types and characteristics of injectable hydrogels,and further summarized their drug loading methods.At the same time,the application of injectable hydrogels in the delivery of various drugs for tumor treatment was discussed in depth.This  review provides dynamic and prospective reference for the potential challenges and possible solutions of the in situ injectable hydrogels for tumor therapy.Injectable hydrogels as drug delivery systems are with good prospects for tumor treatment.
综述

经皮电刺激治疗胃食管反流病的研究进展

Advances in the treatment of gastroesophageal reflux disease by transcutaneous electrical stimulation

:1028-1034
 
        胃食管反流病是一种以烧心和反流为主要症状的胃食管动力障碍性疾病,现有的常规治疗存在药物依赖,手术风险高且易复发等局限性,而经皮电刺激作为一种新兴疗法,在治疗动力障碍性疾病时具有非侵入性、可逆性及调节生理功能的优势。因此本研究为了探讨经皮电刺激治疗胃食管反流病的进展,现从胃食管反流病的神经调控生理、不同经皮电刺激对治疗胃食管反流病的研究以及应用效果等方面进行综述,以期为胃食管反流病提供新的诊断思路和方法。
    In order to discuss the progress of transcutaneous electrical stimulation for the treatment of gastroesophageal reflux disease(GERD),the physiology of neuromodulation of GERD,the research on different transcutaneous electrical stimulation for the treatment of GERD,and the application effect were reviewed,with the aim of providing new diagnostic ideas and methods for GERD.
专家述评

糖尿病肾病的重要治疗进展:从基础研究到临床应用

Important advances in diabetic nephropathy treatment:From basic research to clinical application

:1006-1020
 
       糖尿病肾病(DN)是指由糖尿病所致的慢性肾脏疾病,是目前我国和全球范围内慢性肾脏疾病和终末期肾脏疾病的首位病因。DN发病率逐年攀升,且预后不良,已成为我国重大的公共卫生问题之一。DN不仅明显降低了患者的生活质量,还增加了心血管疾病的风险。随着对DN发病机制的深入研究,近十余年来在DN治疗手段方面取得了显著进展,包括新型药物的研发、生活方式的干预及各种新兴疗法的探索。本文旨在系统性综述近年来DN领域的重要治疗进展,阐明这些进展在临床应用中的有效性和适用性,并展望未来的研究方向,以期为临床实践提供参考和指导。
       Diabetic nephropathy(DN)is a form of chronic kidney disease(CKD)induced by diabetes.Diabetic nephropathy represents the leading cause of CKD and end-stage renal disease both in China and globally.The incidence of DN has been steadily increasing and its prognosis remains unfavorable.Diabetic nephropathy has become a major public health concern.Diabetic nephropathy not only significantly affects patients’ quality of life but also increases the risk of cardiovascular diseases.Recent advancements in our understanding of the pathogenesis of DN have facilitated significant progress in treatment options over the past decade.These developments include the introduction of novel pharmacological agents,the implementation of lifestyle modifications,and the exploration of various emerging therapeutic approaches.This  review aims to  systematically expound the significant therapeutic advancements in the field of DN in recent years,evaluate the efficacy and applicability of these advancements in clinical practice,and explore potential future research directions,thereby providing valuable insights andguidance for clinical practice.
论著

达格列净联合沙库巴曲缬沙坦治疗射血分数降低的心力衰竭患者的疗效

Efficacy of dapagliflozin combined with sacubitril/valsartan in the treatment of heart failure with reduced ejection fraction

:988-994
 
        目的   分析达格列净联合沙库巴曲缬沙坦治疗射血分数降低的心力衰竭(HFrEF)效果。方法  连续抽取2021年1月—2023年6月在广州市第一人民医院心内科住院的射血分数降低的心力衰竭(HFrEF)患者203例,随访至少6个月,按照接受的治疗进行分组。对照组予常规治疗和沙库巴曲缬沙坦治疗;观察组予常规治疗、沙库巴曲缬沙坦和达格列净治疗;对比两组疗效,观察指标包括住院时间,入院及出院后6个月的心功能状态(NYHA纽约心脏病协会心功能分级)、心脏超声指标左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末内径(LVSDD)、血液指标-端脑钠肽前体(NT-proBNP N)、糖化血红蛋白(HBA1c)、血肌酐(Cr)、6个月时的再住院率及全因死亡率。结果   观察组心脏监护病房(CCU)停留时间(2.54±1.26)d,短于对照组的(3.73±1.21)d;观察组6个月时观察组心功能NYHA改善≥2级比例为95.05%高于对照组的86.27%,差异有统计学意义(P<0.05);观察组6个月时的LVEDD、LVESD水平分别为(48.22±7.35)(34.61±4.32)mm,低于对照组的(51.47±8.02)(43.07±5.33)mm,LVEF为(51.49±5.40)%,高于对照组的(46.18±4.21)%,差异有统计学意义(P<0.05);6个月时观察组的NT-proBNP为(415.58±31.57)pg/mL,低于对照组的(520.23±385.56)pg/mL,差异有统计学意义(P<0.05);两组的住院时间、血清肌酐(Cr)、HBA1c、6个月时的再住院率、全因病死率对比,差异不显著(P>0.05)。观察组HBA1c值为(6.04±0.66)mmol/L,高于对照组的(5.20±0.56)mmol/L(P<0.05)。结论  HFrEF患者采取达格列净+沙库巴曲缬沙坦治疗,可通过协同作用,缩短CCU停留时间,改善患者6个月时的心功能状态,降低NT-proBNP值,减少心脏扩大趋势,提高LVEF水平。

       Objective  To analyze the efficacy of  dapagliflozin combined with  sacubitril/valsartan in the treatment of heart failure with reduced ejection fraction(HFrEF).Methods  A total of 203 patients with HFrEF who were hospitalized in the cardiology department of the hospital between January 2021 and June 2023 were enrolled and followed up for at least six months.Patients were divided into groups based on their treatment regimens:the control group received conventional treatment plus sacubitril/valsartan,while the observation group received conventional treatment plus sacubitril/valsartan and dapagliflozin.The two groups were compared for clinical outcomes,including length of hospital stay,cardiac function(NYHA classification)at admission and six months after discharge,echocardiographic indicators(LVEF,LVEDD,LVESD),blood indicators(NT-proBNP,HbA1c,creatinine),six-month rehospitalization rate,and all-cause mortality.Results  The observation group had a shorter CCU stay(2.54±1.26 days)compared to the control group(3.73±1.21 days).At sixth month,the proportion of patients in the observation group with an NYHA improvement ≥2 grades(95.05%)was significantly higher than that in the control group(86.27%)P<0.05).The observation group demonstrated lower LVEDD(48.22±7.35 mm)and LVESD(34.61±4.32 mm)levels and higher LVEF(51.49±5.40%)compared to the control group(LVEDD:[51.47±8.02] mm,LVESD:[43.07±5.33]mm,LVEF:[46.18±4.21]%)(P<0.05).NT-proBNP levels in the observation group([415.58±31.57] pg/mL)were significantly lower than those in the control group([520.23±385.56] pg/ml)(P<0.05).There were no significant differences between the two groups in length of total hospital stay,serum creatinine,HbA1c,six-month rehospitalization rate,or all-cause mortality(P>0.05).However,HbA1c levels in the observation group([6.04±0.66] mmol/L)were higher than those in the control group([5.20±0.56] mmol/L)(P<0.05).Conclusions  The combination of dapagliflozin and sacubitril/valsartan in the treatment of HFrEF patients can exert a synergistic effect,shorten CCU stay,improve cardiac function at sixth month,reduce NT-proBNP levels,mitigate cardiac dilation,and increase LVEF.

论著

LP-PRP 对比 LR-PRP 联合 ESWT 治疗慢性非止点跟腱腱病的对比研究

Comparative study of LP-PRP and LR-PRP combined with ESWT in the treatment of chronic non insertional Achilles tendinopathy

:963-967
 
       目的   对比乏白细胞富血小板血浆(LP-PRP)与富白细胞富血小板血浆(LR-PRP)联合体外冲击波疗法(ESWT)治疗慢性非止点跟腱腱病(NIAT)的临床价值。方法   选取2021年12月—2023年12月赣州市人民医院收治的80例慢性NIAT患者,以随机数表法分为两组,即对照组和观察组各40例,观察组予LP-PRP联合ESWT治疗,对照组予LR-PRP联合ESWT治疗;于治疗前、第一次治疗后1个月、3个月比较两组疼痛度[视觉模拟量表(VAS)评分]、跟腱病变程度[维多利亚体育研究所跟腱评估问卷(VISA-A)]、跟腱功能(Arner-Lindholm跟腱功能评分),并比较两组并发症的发生率。结果   两组在治疗后1个月、3个月的VAS评分下降,VISA-A评分升高,且观察组治疗后3个月的VAS评分(1.05±0.31)分低于对照组的(1.82±0.45)分,VISA-A评分(83.35±5.58)分高于对照组的(76.28±5.35)分(F组间与时点交互=338.478、106.663,均P<0.05);治疗后3个月,观察组跟腱功能(优、良、差各有24、13、3例)优于对照组(优、良、差各有14、16、10例),差异有统计学意义(Z=2.529,P=0.012)。两组治疗后1个月时VAS评分、VISA-A评分及跟腱功能比较差异无统计学意义(均P>0.05)。结论   与LR-PRP比较,LP-PRP联合ESWT治疗慢性NIAT更有利于减轻患者跟腱疼痛度及病变程度,改善患者跟腱功能。
       Objective  To compare the clinical value of leukocyte-poor platelet rich plasma(LP-PRP)and leukocyte-rich platelet rich plasma(LR-PRP)combined with extracorporeal shock wave therapy(ESWT)in the treatment of chronic non insertional Achilles tendinopathy(NIAT).Methods
Eighty patients with chronic NIAT admitted to Ganzhou People’s Hospital from December 2021 to December 2023 were randomly divided into two groups using a random number table method:a control group and an observation group,with 40 patients in each group.The observation group received LP-PRP combined with ESWT treatment,while the control group received LR-PRP combined with ESWT treatment.The pain level(Visual Analog Scale[VAS]score),degree of Achilles tendon lesion(Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire[VISA-A]),and Achilles tendon function(Arner Lindholm Achilles tendon function score)between the two groups were compared before treatment,one month after the first treatment,and three months after treatment,as well as the incidence of complications between the two groups.Results  The VAS scores of both groups decreased and the VISA-A scores increased at one and three months after treatment.The VAS score of the observation group(1.05±0.31)was lower than that of the control group(1.82±0.45)at three months after treatment,while the VISA-A score of the observation group(83.35±5.58)was higher than that of the control group(76.28±5.35)(interaction between group and time point F=338.478,106.663,both P<0.05).After three months of treatment,the Achilles tendon function of the observation group(24 cases of excellent,13 cases of good,and three cases of poor)was better than that of the control group(14 cases of excellent,16 cases of good,and  10 cases ofpoor),and the difference was statistically significant(Z=2.529,P=0.012).There was no  statistically  significant difference in VAS score,VISA-A score,and Achilles tendon function between the two groups one month after treatment(all P>0.05).Conclusions  Compared with LR-PRP,LP-PRP combined with ESWT was more beneficial in reducing the degree of Achilles tendon pain and lesions in patients with chronic NIAT,and improving Achilles tendon function.
论著

窄带成像结合放大内镜和超声内镜评估在早期结直肠癌内镜下治疗前的价值

Application value of magnifying endoscopy combined with narrow band imaging and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer

:957-962
 
       目的   分析早期结直肠癌内镜下治疗前行窄带成像结合放大内镜 (ME-NBI)和超声内镜技术的评估价值。方法   采用回顾性分析方法,以2021年1月— 2023 年 12月中山市第五人民医院收治的102例早期结直肠癌患者为观察对象,所有患者均接受内镜下黏膜切除术(EMR)或内镜黏膜下剥离术(ESD)治疗,根据内镜下治疗前是否进行ME-NBI和超声内镜检查分为研究组与对照组各51例。比较两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理特征;比较两组治疗时间、ESD治疗后非治愈性切除发生率、治愈性切除率、并发症发生情况及再次ESD或外科手术治疗率。结果   两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理比较差异均无统计学意义(P>0.05)。研究组中37例行ESD治疗,治疗时间为(120.6±140.3)min,12例行EMR治疗,治疗时间为(11.6±9.3)min,有2例不符合内镜下治疗指征,转外科手术治疗。对照组有38例行ESD治疗,治疗时间为(128.8±144.5)min,13例行EMR治疗,治疗时间为(12.5±9.5)min,两者治疗时间比较差异均无统计学意义(P>0.05)。研究组非治愈性切除率为7.84,低于对照组27.45;治愈性切除率为88.24,高于对照组72.55;研究组ESD手术并发症为8.11%,低于对照组31.58;ESD或外科手术率为6.12,低于对照组25.49P<0.05),结论  ME-NBI和超声内镜对早期结直肠癌患者行内镜下治疗指征评估更准确,可提高治愈性切除率
       Objective  To  study the application value of magnifying endoscopy combined with  narrow  band imaging (ME-NBI)and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer.Methods  A retrospective analysis was carried out on  102  patients with early-stage colorectal cancer who were admitted to Zhongshan Fifth People’s Hospital from January 2021 to December 2023.All patients were treated with endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESO).The patients were divided into study group(51 cases)and control group(51 cases)according to whether ME-NBI and ultrasonic endoscopy was performed before endoscopic treatment or not.The patient age,sex,volume of tumor,location of tumor and pathological result of the tumor were compared between two groups.Time for treatment,curative resection rate,non-curative resection rate and the complication incidence of ESD,incidences of second ESD or surgery were compared between the two groups.Results  There were no statistical differences in age,sex,volume of tumor,location of tumor and pathological result of the tumor(P>0.05).In the study group,37 patients received ESD treatment,operation time was(120.6±140.3)minutes,and 12 patients received EMR treatment,operation time was(11.6±9.3)minutes,two cases were transferred to surgery due to endoscopic ultrasonography combined with magnifying endoscopy showed that they did not meet the indications for ESD treatment.In the control group,38 patients received ESD treatment,operation time was(128.8±144.5)minutes,13 patients received EMR treatment,operation time was(12.5±9.5)minutes.There was no significant difference in treatment duration between the two groups.The non-curative resection rate of the study group was 7.84%,which was significantly lower than that in the control group(27.45%),and the curative resection rate(88.24%)was significantly higher than that in the control group(72.55%).The complications of ESD surgery in the study group were 8.11%,lower than 31.58% in the control group.The rate of second ESD or surgery was 6.12%,lower than 25.49% in the control group(P<0.05).Conclusions  ME-NBI and endoscopic ultrasound are more accurate in the evaluation of endoscopic indications for early colorectal cancer patients,and can improve the curative resection rate.
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