内镜黏膜下剥离术治疗早期胃癌40例临床分析
Clinical analysis of endoscopic submucosal dissection treatment for early gastric cancer of forty patients

郑晓丽,向兴朝.内镜黏膜下剥离术治疗早期胃癌40例临床分析[J].内科急危重症杂志,2016,22(5):

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英文关键词:Endoscopic submucosal dissection early gastric cancer

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作者	单位	E-mail
郑晓丽	湖北省恩施州中心医院	1052985976@qq.com
向兴朝	湖北省恩施州中心医院	eszyyXiangxingchao@163.com

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中文摘要:

目的比较内镜黏膜下剥离术与外科手术治疗早期胃癌的临床疗效。方法回顾性分析2010年4月到2015年3月,在我院接受治疗的80例早期胃癌患者的临床资料,根据治疗方式的不同分为ESD组和外科手术组。对两组患者的病灶切除率、手术时间、住院时间、医疗费用、以及术后并发症等进行比较。结果ESD组和外科手术组,病灶治愈性切除率均为100%,两组比较无统计学差异(P＞0.05)。ESD组与外科手术组比较,平均手术时间缩短(89.3vs 215.4 min,P＜0.05),平均住院时间缩短(10.5 vs 22.5 d,P＜0.05),平均医疗费用减少(1.79 vs 5.93万元,P＜0.05)。ESD组术后并发胃食管反流1例,感染1例(肺部感染),狭窄1例,出血1例,总发生率10.0%(4/40)；外科手术组术后并发胃食管反流7例,感染5例(肺部感染1例,创口感染4例),狭窄2例,出血6例,总发生率50.0%(20/40),术后并发症发生率明显高于ESD组。结论内镜黏膜下剥离术治疗早期胃癌疗效确切,而且具有手术和住院时间短,医疗费用少,术后并发症发生率低等特点。

英文摘要:

Objective To observe the clinical efficacy of endoscopic submucosal dissection and surgical treatment for early gastric cancer. Methods Retrospective analysis clinical datas of 80 patients with early gastric cancer in our hospital from April 2010 to March 2015. All of the patients were divided into ESD group and surgery group, according to the different treatment methods. The resection rate, operation time, length of stay, medical cost and postoperative complications were compared between the two groups.Results The rate of resection was 100.0% of ESD group and surgical group, the two groups were not statistically significant difference (P＞0.05). The average operative time (89.3 vs 215.4 min, P < 0.05), the average hospitalization time (10.5 vs 22.5 D, P < 0.05), the average medical cost (versus 1.79 5.93 million yuan, P < 0.05),of the ESD group were significantly reduced than the surgery group. There were 1 cases of gastroesophageal reflux, 1 cases of infection, 1 cases of stenosis and 1 cases of bleeding in the ESD group, and the total incidence rate was 10.0% (4/40). There were 7 cases of gastroesophageal reflux, 5 cases of infection, 2 cases of stenosis and 6 cases of bleeding in the ESD group, and the total incidence rate was 50.0% (20/40),the incidence of postoperative complications was significantly higher than the ESD group. Conclusion Endoscopic submucosal dissection in the treatment of early gastric cancer is effective, and has the advantages of short operation and hospital stay, less medical expenses, and low incidence of postoperative complications.