摘要
目的探讨内镜黏膜下剥离术治疗贲门部早癌及癌前病变的临床效果。方法选取2018年6月—2019年6月该院收治的60例贲门部早癌及癌前病变患者,依据随机数表法分为两组,各30例。对照组予以腹腔镜下切除术治疗,观察组予以内镜黏膜下剥离术治疗。对比两组患者手术治疗情况、病灶切除情况与术前、术后6个月生活质量及疼痛程度以及术后并发症发生情况。结果观察组手术用时(56.37±14.28)min、恢复正常进食时间(12.45±0.36)d与住院时间(3.57±1.16)d均较短于对照组(66.53±13.57)min、(13.17±0.28)d、(5.12±1.09)d,术中出血量(29.64±7.38)mL少于对照组(34.82±6.42)mL,差异有统计学意义(t=2.825,P=0.007;t=8.647,P<0.001;t=5.334,P<0.001;t=2.901,P=0.005)。相比于对照组(73.33%),观察组病灶整块切除率(93.33%)较高,差异有统计学意义(χ2=4.320,P=0.038),对比两组病灶完全切除(20.00%vs 6.67%)以及治愈性切除率(6.67%vs 0.00%),差异无统计学意义(χ2=1.298,P=0.255;χ2=0.517,P=0.472)。对比两组术前QOL评分(25.41±2.76)分vs(25.37±2.81)分及VAS评分(6.98±1.13)分vs(6.96±1.17)分,差异无统计学意义(t=0.056,P=0.956;t=0.067,P=0.947);术后6个月两组QOL评分上升、VAS评分下降,且观察组QOL评分(54.28±3.16)分高于对照组(51.12±2.83)分,VAS评分(1.21±0.14)分低于对照组(1.67±0.23)分,差异有统计学意义(t=4.080、9.357,P<0.05)。相比于对照组(26.67%),观察组术后并发症发生率(3.33%)较低,差异有统计学意义(χ2=4.706,P=0.030)。结论贲门部早癌及癌前病变患者采用内镜黏膜下剥离术治疗效果确切,可有效缩短手术时间并减少术中出血量,可提高病灶整块切除率,同时提升生活质量并减轻疼痛,还可减少术后并发症。
Objective To investigate the clinical effect of endoscopic submucosal dissection for early cancer and precancerous lesions of the cardia. Methods A total of 60 patients with early cardia cancer and precancerous lesions in the hospital from June 2018 to June2019 were selected and divided into 2 groups according to the random number table method, 30 cases in each group. The control group received laparoscopic resection for treatment, the observation group was treated with endoscopic submucosal dissection. The sur-gical treatment, lesion resection, quality of life and pain degree before and 6 months after surgery and the occurrence of postoperative complications were compared between the two groups. Results The observation group’s operation time(56.37 ±14.28)min, normal eating time(12.45±0.36)d and hospitalization time(3.57±1.16) d were shorter than those of the control group(66.53±13.57)min,(13.17±0.28)d,(5.12±1.09)d, and the intraoperative blood loss(29.64±7.38)mL was less than the control group(34.82±6.42)mL, the difference was statistically significant(t=2.825, P=0.007;t=8.647, P<0.001;t=5.334, P<0.001;t=2.901, P=0.005). Compared with the control group(73.33%), the observation group had a higher rate of mass resection(93.33%), and the difference was statistically significant(χ~2=4.320, P=0.038). The two groups were compared with complete resection(20.00% vs 6.67%) and curative resection rate(6.67% vs0.00%), the difference was not statistically significant(χ~2=1.298, P=0.255;χ~2=0.517, P=0.472). The preoperative QOL scores(25.41±2.76)points vs(25.37±2.81)points and VAS scores(6.98±1.13)points vs(6.96±1.17)points were compared between the two groups before operation. The difference was not statistically significant(t=0.056, P=0.956;t=0.067, P=0.947);6 months after the operation, the QOL score of the two groups increased and the VAS score decreased, and the QOL score of the observation group(54.28±3.16)points was higher than the control group(51.12±2.83)points, and the VAS score(1.21 ±0.14)point
作者
闫坤锋
YAN Kun-feng(Department of Gastroenterology,Taixing People's Hospital,Taixing,Jiangsu Province,225400 China)
出处
《世界复合医学》
2020年第10期20-23,共4页
World Journal of Complex Medicine
关键词
贲门部早癌及癌前病变
内镜黏膜下剥离术
腹腔镜下切除术
Early cancer and precancerous lesions of the cardia
Endoscopic submucosal dissection
Laparoscopic resection
