摘要
目的观察内镜黏膜下剥离术在未分化型早期胃癌治疗中的应用价值。方法收集莒南县人民医院82例未分化型早期胃癌患者的临床资料后开展回顾性分析,患者就诊时间均为2018年7月-2020年6月,其中,有41例患者接受外科手术治疗,有41例患者接受内镜黏膜下剥离术治疗,将前者归入甲组,将后者归入乙组,记录两组手术过程中的失血量、手术时间以及术后住院时间,采用视觉模拟评分法(VAS)评估两组的疼痛程度,对比两组并发症(穿孔、出血、感染)发生率及总体疗效。结果甲组的术中失血量为(217.11±18.27)mL、手术时间为(190.03±23.39)min、住院时间为(12.28±3.39)d、胃肠减压时间为(5.51±2.11)d,乙组的术中失血量为(20.38±2.19)mL、手术时间为(47.26±10.22)min、住院时间为(6.37±2.84)d、胃肠减压时间为(3.05±1.42)d,两组在围手术指标比较上差异显著(P<0.05);甲组在术后1d的疼痛评分为(7.19±0.39)分,乙组在术后1d的疼痛评分为(7.21±0.41)分,两组在术后1d的疼痛评分比较无显著差异性(P>0.05);甲组在术后3d、5d、7d的疼痛评分与乙组在术后3d、5d、7d的疼痛评分比较两组差异显著(P<0.05);甲组的总体疗效例数为35例,占比为85.37%,乙组的总体疗效例数为40例,占比为97.56%,甲组的总体疗效显著低于乙组,差异有统计学意义(P<0.05);甲组出现穿孔2例、出血2例、感染2例、腹胀2例,并发症发生率为19.51%,乙组出现2例腹胀患者,并发症发生率为4.88%,甲组并发症较乙组高,差异有统计学意义(χ^(2)=4.100,P<0.05)。结论内镜黏膜下剥离术在未分化型早期胃癌的治疗中效果显著,可避免术中失血过多,减轻患者疼痛,降低穿孔、出血、感染等并发症的发生风险,有利于术后恢复。
Objective To observe value of endoscopic submucosal dissection in treatment of undifferentiated early gastric cancer.Methods The paper collected clinical data of 82 patients with undifferentiated early gastric cancer in Junan County People's hospital for analysis and review.Treatment time of patients was from July 2018 to June 2020.Among them,41 cases were treated with surgery and 41 cases with endoscopic submucosal dissection.The former was classified into group A and the latter into group B.Blood loss,operation time and postoperative hospital stay between two groups was recorded,and pain degree was evaluated between two groups with visual analogue scale(VAS),and incidence of complications(perforation,bleeding,infection)and overall curative effect was compared between two groups.Results Intraoperative blood loss in group A was(217.11±18.27)ml,operation time was(190.03±23.39)min,hospital stay was(12.28±3.39)d,gastrointestinal decompression time was(5.51±2.11)d,and intraoperative blood loss in group B was(20.38±2.19)ml,operation time was(47.26±10.22)min,hospital stay was(6.37±2.84)d,gastrointestinal decompression time was(3.05±1.42)d.There was significant difference in perioperative indexes between two groups(P<0.05);pain scores of group A on the first day after operation was(7.19±0.39)and group B on the first day after operation was (7.21±0.41). There was no significant difference between two groups on the first day after operation(P>0.05);pain scores of group A at 3d, 5d and 7d after operation was significantly different from groupB at 3d, 5d and 7d after operation (P<0.05);overall effect of group A was 35 cases, accounting for 85.37%,and that of group B was 40 cases, accounting for 97.56%. Overall effect of group A was significantlylower than group B (P<0.05);there were 2 cases of perforation, 2 cases of bleeding, 2 cases of infectionand 2 cases of abdominal distension in group A, and complication incidence was 19.51%. There were2 cases of abdominal distension in group B, and complication incdience wa
作者
李克波
LI Kebo(Gastroenterology Department,Junan County People's Hospital,Linyi,Shandong,276600)
出处
《智慧健康》
2022年第18期65-69,共5页
Smart Healthcare
关键词
内镜黏膜下剥离术
未分化型早期胃癌
并发症
临床效果
Endoscopic submucosal dissection
Undifferentiated early gastric cancer
Complications
Clinical effect
