内镜下粘膜切除术和粘膜剥离术治疗消化道早癌的短期疗效评估-论文.pdf

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1、·190·医学新知杂志2015年第25卷第3期内镜下粘膜切除术和粘膜剥离术治疗消化道早癌的短期疗效评估贺琼李国珍【摘要】目的考察内镜下粘膜切除术(EMR)和粘膜剥离术(ESD)治疗}肖化道早癌的短期疗效。方法选取消化道早癌患者80例，分别采取ESD(40例)和EMR(40例)治疗。比较两组患者完全切除率、整块切除率、术中出血率、术中穿孔率、术后并发症发生率和1年内复发率。结果ESD组整块切除率和完全切除率分别为97．5％和92．5％，显著高于EMR组的77．5％和70．0％(P<0．叭)。EMR组术中出血率为2．5％，显著低于ESD组的7．5％(P<0．05)

2、。ESD组穿孔率为0，与EMR组(2．5％)比无统计学差异(P>0．05)。两组间术后恢复情况无统计学差异(P>0．05)。ESD组患者出现1例切口感染，EMR组无明显术后不良反应，两组间无统计学差异(P>0．05)。ESD组1年内复发率为2．5％，显著低于EMR组的7．5％(P<0．05)。结论内镜下粘膜剥离术治疗消化道早癌临床疗效更优。【关键词】食管癌；胃癌；大肠癌；粘膜切除术；粘膜剥离术【中图分类号】R735【文献标识码】A【文章编号】1004—551i(2015)03-0190-03Short—termEficacyEvaluati0nOfEndosc

3、opicMucosalResectionandEndoscopicSubmucosalDissectionintheTreatmentofGastrointestinalTumorsHeQiong，LiGuozhenDepartmentofGastroenterology，WuhanEleventhHospital，Wuhan430015，China【Abstract】ObjectiveToinvestigateshort—termeficacyofendoscopicmucosalresection(EMR)andendoscop—icsubmucosald

4、issection(ESD)inthetreatmentofgastrointestinaltumors．Metllods80patientswithgastrointestinaltumorwererandomlydividedintoESDgroupandEMRgroupwith40casesineachgroup．Thecompleteresectionrate，wholeblockresectionrate，intraoperativebleedingrate，intraoperativeperforationrate，postoperativemor

5、bidityrateand1yearsurvivalratewerecomparedbetweenthetwogroups．ResultsThewholeblockresectionrate(97．5％)andcompleteresectionrate(92．5％)inESDgroupweresignificantlyhigherthanthoseinEMRgroup(77．5％and70．0％)(P<0．01)．Theintraoperativebleedingrateincontrolgroupwas2．5％，whichwassignificantlylo

6、werthanthatinESDgroup(7．5％)(P<0．05)．Therateofperforationwas2．5％inEMRgroupversus0inESDgroup．Therewasnosignificantdifferencebetweenthetwogroups(P>0．05)．Therewasnosignificantdifferenceinpostoperativerecoverybetweenthetwogroups(P>0．05)．Therewere1caseofwoundinfectioninESDgroup，whilenoobv

7、iousad—versereactionoccurredinEMRgroup．Therewasnosignificantdifferencebetweenthetwogroups(P>0．05)．1yearrecurrencerateinESDgroupwas2．5％versus7．5％incontrolgroup．Therewassignificantdifferencebetweenthetwogroups(P<0．05)．ConclusionEndoscopicsubmucosaldissectionismoreeffectiveinthetreatme

8、ntofgastroin—testin