摘要
目的分析超声内镜引导内镜黏膜下剥离术(ESD)治疗固有肌层的胃黏膜下肿瘤患者的有效性及安全性。方法选取我院2021年1月至12月收治的60例固有肌层的胃黏膜下肿瘤患者,随机将其分为开腹组(30例,传统开腹手术)和微创组(30例,超声内镜引导ESD)。比较两组的临床效果。结果微创组的手术切口长度短于开腹组,手术时长显著长于开腹组,术中失血量少于开腹组(P<0.05);两组的淋巴结清扫数量比较,差异无统计学意义(P>0.05)。微创组的术后排气时间、卧床时间、恢复正常饮食时间及住院时间短于开腹组(P<0.05)。微创组的术后并发症总发生率低于开腹组(P<0.05);两组的1年内复发率比较,差异无统计学意义(P>0.05)。术后,微创组的C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)、胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)及胃蛋白酶原Ⅱ(PGⅡ)水平低于开腹组(P<0.05)。结论超声内镜引导ESD治疗固有肌层的胃黏膜下肿瘤患者可取得理想手术效果,且具有较高预后保障。
Objective To analyze the efficacy and safety of endoscopic ultrasound-guided endoscopic submucosal dissection(ESD)for gastric submucosal tumors originating from the muscularis propria in patients.Methods A total of 60 patients with gastric submucosal tumors originating from the muscularis propria admitted in our hospital from January to December 2021 were selected and randomly divided into laparotomy group(30 cases,traditional laparotomy)and minimally invasive group(30 cases,endoscopic ultrasound-guided ESD).The clinical effects of the two groups were compared.Results The surgical incision length of the minimally invasive group was shorter than that of the laparotomy group,the operation time was significantly longer than that of the laparotomy group,and the intraoperative blood loss was less than that of the laparotomy group(P<0.05);there was no significant difference in the number of lymph node dissection between the two groups(P>0.05).The postoperative exhaust time,bed rest time,normal diet recovery time and hospitalization time in the minimally invasive group were shorter than those in the laparotomy group(P<0.05).The total incidence of postoperative complications in the minimally invasive group was lower than that in the laparotomy group(P<0.05);there was no significant difference in the recurrence rate within 1 year between the two groups(P>0.05).After operation,the levels of C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC),gastrin(GAS),pepsinogenⅠ(PGⅠ)and pepsinogenⅡ(PGⅡ)in the minimally invasive group were lower than those in the laparotomy group(P<0.05).Conclusion Endoscopic ultrasound-guided ESD can achieve ideal surgical results in patients with gastric submucosal tumors originating from the muscularis propria,and has a high prognosis.
作者
黄远伟
HUANG Yuanwei(Xinyang Shencheng Hospital,Xinyang 464000,China)
出处
《临床医学研究与实践》
2025年第22期70-73,共4页
Clinical Research and Practice
关键词
固有肌层
胃黏膜下肿瘤
超声内镜引导
内镜黏膜下剥离术
muscularis propria
gastric submucosal tumor
endoscopic ultrasound-guide
endoscopic submucosal dissection
