早期胃癌内镜下黏膜剥离术与常规手术对比及患者2年期复发率分析(1)
【摘要】 目的：对比内镜下黏膜剥离术与常规手术治疗早期胃癌患者的效果以及2年复发率。方法：选取2014年12月-2016年12月本院收治的早期胃癌患者94例。按照随机数字表法将其分为观察组和对照组，各47例。对照组予以常规手术治疗，观察组则予以内镜下黏膜剥离术治疗。比较两组各项手术指标水平、术后并发症发生情况、临床疗效以及术后1、2年复发率。结果：观察组手术时间、术中出血量、抗菌药物使用时间、住院时间、住院费用均少于对照组，差异均有统计学意义(P<0.05);观察组术后穿孔发生率以及并发症发生率均高于对照组，差异均有统计学意义(P<0.05);两组整块切除率、治愈性切除率以及术后1、2年复发率比较，差异均无统计学意义(P>0.05)。结论：内镜下黏膜剥离术治疗早期胃癌效果更佳且有利于促进患者术后早日康复，降低术后并发症发生风险的同时不会增加术后复发率。
【关键词】 早期胃癌; 内镜下黏膜剥离术; 常规手术; 复发率; 并发症
【Abstract】 Objective：To compare the efficacy of endoscopic mucosal dissection and conventional surgery in treatment of early gastric cancer patients and the 2-year recurrence rate.Method：A total of 94 patients with early gastric cancer admitted to our hospital from December 2014 to December 2016 were selected.According to the random number table method，they were divided into observation group and control group，47 cases in each group.The control group was treated with conventional surgery，while observation group was treated with endoscopic mucosal dissection.The levels of surgical indicators，the occurrence of complications，clinical efficacy and the recurrence rate in 1 or 2 years after operation between two groups were compared.Result：The operation time，intraoperative bleeding volume，antimicrobial use time，hospitalization time and hospitalization expenses of observation group were less than those of control group，the differences were statistically significant(P<0.05).The incidences of perforation and complications in observation group were higher than those of control group，the differences were statistically significant(P<0.05).The rates of total excision，curative excision and recurrence 1 or 2 years after operation in two groups were compared，the differences were noy statistically significant(P>0.05).Conclusion：Endoscopic mucosal dissection is more effective in treatment of early gastric cancer，which is conducive to the early postoperative recovery of patients，reduces the risk of postoperative complications，and does not increase the rate of postoperative recurrence.
【Key words】 Early gastric cancer; Endoscopic mucosal dissection; Conventional surgery; Recurrence rate; Complications
First-author’s address：Jingshan People’s Hospital，Jingshan 431800，China
doi：10.3969/j.issn.1674-4985.2019.09.029
胃癌具有较高的发病率以及死亡率，严重威胁着人们的生命健康安全[1]。随着近年来医疗水平的不断进步以及影像学诊断技术的迅速发展，早期胃癌的临床检出率得以显著的提高[2]。对于早期胃癌患者而言根治性手术是国内外所公认的最佳治疗方式，不仅有利于改善患者临床症状，同时可显著提高术后存活率[3]。常规外科手术虽然在早期胃癌患者的治疗中具有一定的疗效，但存在手术创伤较大以及术后并发症发生风险较高等缺陷，不利于患者术后的康复，存在一定的局限性[4]。随着近年来内镜技术于早期胃癌患者诊治中的应用日益广泛，内镜黏膜切除术及内镜下黏膜剥离术开始被进入医务人员以及患者的视线中。其中内镜下黏膜剥离术主要是在內镜黏膜切除术的基础上发展而来，相比内镜黏膜切除术而言，内镜下黏膜剥离术的适应证较为广泛，且有利于提高早期胃癌的一次性完整切除率，降低术后复发率[5]。本文对比内镜下黏膜剥离术与常规手术治疗早期胃癌患者的效果以及2年复发率，以期为早期胃癌患者提供一种更加安全、有效的治疗方式。现报道如下。, 百拇医药(江小宇)
【关键词】 早期胃癌; 内镜下黏膜剥离术; 常规手术; 复发率; 并发症
【Abstract】 Objective：To compare the efficacy of endoscopic mucosal dissection and conventional surgery in treatment of early gastric cancer patients and the 2-year recurrence rate.Method：A total of 94 patients with early gastric cancer admitted to our hospital from December 2014 to December 2016 were selected.According to the random number table method，they were divided into observation group and control group，47 cases in each group.The control group was treated with conventional surgery，while observation group was treated with endoscopic mucosal dissection.The levels of surgical indicators，the occurrence of complications，clinical efficacy and the recurrence rate in 1 or 2 years after operation between two groups were compared.Result：The operation time，intraoperative bleeding volume，antimicrobial use time，hospitalization time and hospitalization expenses of observation group were less than those of control group，the differences were statistically significant(P<0.05).The incidences of perforation and complications in observation group were higher than those of control group，the differences were statistically significant(P<0.05).The rates of total excision，curative excision and recurrence 1 or 2 years after operation in two groups were compared，the differences were noy statistically significant(P>0.05).Conclusion：Endoscopic mucosal dissection is more effective in treatment of early gastric cancer，which is conducive to the early postoperative recovery of patients，reduces the risk of postoperative complications，and does not increase the rate of postoperative recurrence.
【Key words】 Early gastric cancer; Endoscopic mucosal dissection; Conventional surgery; Recurrence rate; Complications
First-author’s address：Jingshan People’s Hospital，Jingshan 431800，China
doi：10.3969/j.issn.1674-4985.2019.09.029
胃癌具有较高的发病率以及死亡率，严重威胁着人们的生命健康安全[1]。随着近年来医疗水平的不断进步以及影像学诊断技术的迅速发展，早期胃癌的临床检出率得以显著的提高[2]。对于早期胃癌患者而言根治性手术是国内外所公认的最佳治疗方式，不仅有利于改善患者临床症状，同时可显著提高术后存活率[3]。常规外科手术虽然在早期胃癌患者的治疗中具有一定的疗效，但存在手术创伤较大以及术后并发症发生风险较高等缺陷，不利于患者术后的康复，存在一定的局限性[4]。随着近年来内镜技术于早期胃癌患者诊治中的应用日益广泛，内镜黏膜切除术及内镜下黏膜剥离术开始被进入医务人员以及患者的视线中。其中内镜下黏膜剥离术主要是在內镜黏膜切除术的基础上发展而来，相比内镜黏膜切除术而言，内镜下黏膜剥离术的适应证较为广泛，且有利于提高早期胃癌的一次性完整切除率，降低术后复发率[5]。本文对比内镜下黏膜剥离术与常规手术治疗早期胃癌患者的效果以及2年复发率，以期为早期胃癌患者提供一种更加安全、有效的治疗方式。现报道如下。, 百拇医药(江小宇)