摘要
目的探索胃间质瘤应用内镜黏膜下剥离术(ESD)与腹腔镜下胃大部切除术治疗的临床效果。方法选取2021年1月至2023年6月肇庆市第一人民医院收治的90例胃间质瘤患者作为研究对象,按照不同的手术治疗方法分为ESD组(n=50)及腔镜组(n=40),ESD组给予ESD治疗,腔镜组给予腹腔镜下胃大部切除术。比较两组患者的肿瘤完整切除率,围手术期指标和术后1、3、5 d的疼痛程度[数字评分量表(NRS)]以及术前、术后3 d的应激反应指标[肾上腺素(E)、去甲肾上腺素(NE)],胃肠激素[胃泌素(GAS)、胃动素(MTL)]水平,并发症发生率。结果ESD组患者手术时间、术后住院时间、术后首次进食时间、术后排气时间短于腔镜组,术中出血量、住院总费用少于腔镜组,差异有统计学意义(P<0.05);两组肿瘤完整切除率比较,差异无统计学意义(P>0.05);ESD组患者术后3、5 d NRS评分低于腔镜组,差异有统计学意义(P<0.05)。术后3 d,两组患者E、NE水平高于同组术前,但ESD组低于腔镜组,差异有统计学意义(P<0.05)。术后3 d,两组患者GAS、MTL水平低于术前,但ESD组高于腔镜组,差异有统计学意义(P<0.05)。两组患者术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论在胃间质瘤患者的临床治疗中,相较于腹腔镜下胃大部切除术,ESD手术效果更好,临床创伤更小,对患者应激反应及胃肠道功能影响更小,且安全可靠。
Objective To explore the clinical effects of endoscopic submucosal dissection(ESD)and laparoscopic subtotal gastrectomy in the treatment of gastric stromal tumors.Methods A total of 90 patients with gastric stromal tumors admitted to the First People's Hospital of Zhaoqing from January 2021 to June 2023 were selected as the research subjects.According to different surgical treatment methods,they were divided into the ESD group(n=50)and the endoscopic group(n=40).The ESD group was treated with ESD surgery,while the endoscopic group was given laparoscopic subtotal gastrectomy.The complete tumor resection rate,perioperative indicators,pain degree(numerical rating scale[NRS])at 1,3,and 5 days after surgery,stress response indicators(epinephrine[E],norepinephrine[NE])before surgery and 3 days after surgery,gastrointestinal hormone(gastrin[GAS],motilin[MTL])levels,and complication rates were compared between the two groups of patients.Results The operation time,postoperative hospital stay,first postoperative feeding time and postoperative exhaust time of patients in the ESD group were shorter than those in the endoscopic group,the intraoperative blood loss and total hospitalization cost were less than those in the endoscopic group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the complete tumor resection rate between the two groups of patients(P>0.05).The NRS scores of patients in the ESD group at 3 and 5 days after surgery were lower than those in the endoscopic group,and the difference was statistically significant(P<0.05).Three days after the operation,the levels of E and NE in both groups were higher than those before the operation,while the levels in the ESD group were lower than those in the endoscopic group after the operation,the differences were statistically significant(P<0.05).Three days after the operation,the levels of GAS and MTL in both groups were lower than those before the operation,while those in the ESD group were higher than those in the endoscopic group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of postoperative complications between the two groups of patients(P>0.05).Conclusion In the clinical treatment of patients with gastric stromal tumors,compared with laparoscopic subtotal gastrectomy,ESD surgery has better results,less clinical trauma,less impact on patients'stress response and gastrointestinal function,and is safe and reliable.
作者
郑小明
陈晓
张增瑞
ZHENG Xiaoming;CHEN Xiao;ZHANG Zengrui(Department of Gastrointestinal Anorectal Surgery,the First People's Hospital of Zhaoqing,Guangdong Province,Zhaoqing526000,China)
出处
《中国当代医药》
2026年第2期35-39,共5页
China Modern Medicine
关键词
胃间质瘤
内镜黏膜下剥离术
腹腔镜下胃大部切除术
临床效果
Gastric stromal tumors
Endoscopic submucosal dissection
Laparoscopic subtotal gastrectomy
Clinical effect
