内镜黏膜下剥离术与外科手术治疗胃早癌的临床疗效及适应症分析.doc

内镜黏膜下剥离术与外科手术治疗早期胃癌的临床疗效的对照研究 郑晓丽（恩施自治州中心医院消化内科，湖北恩施 445000） [摘要]目的比较内镜黏膜下剥离术与外科手术治疗胃早癌的临床疗效。方法选取2010年4月到2015年3月，在我院接受治疗的患者的临床资料，根据治疗方式的不同分为ESD组和外科手术组。对两组患者的病灶切除率、手术时间、住院时间、医疗费用、以及术后并发症等进行比较。结果ESD组和外科手术组，病灶治愈性切除率均为100%，两组比较无统计学差异（P＞0.05）。ESD组与外科手术组比较，平均手术时间缩短（89.3vs 215.4 min，P＜0.05），平均住院时间缩短（10.5 vs 22.5 d，P＜0.05），平均医疗费用减少（1.79 vs 5.93万元，P＜0.05）。ESD组术后并发胃食管反流1例，感染1例（肺部感染），狭窄1例，出血1例，总发生率10.0%（4/40）；外科手术组术后并发胃食管反流7例，感染5例（肺部感染1例，创口感染4例），狭窄2例，出血6例，总发生率50.0%（2/40），术后并发症发生率明显高于ESD组。结论内镜黏膜下剥离术治疗癌疗效确切，而且具有手术和住院时间短，医疗费用少，术后并发症发生率低等特点。 [关键词]内镜黏膜下剥离术； Clinical efficacy of endoscopic submucosal dissection and surgical treatment for early gastric cancer ZHENG Xiaoli, Xiang xingchao（GI Medicine, The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei 445000, China） [Abstract]ObjectiveTo observe the clinical efficacy of endoscopic submucosal dissection and surgical treatment for early gastric cancer. Methods 80 patients with early gastric cancer in our hospital from April 2010 to March 2015 were selected..All of the patients were divided into ESD group and surgery group, according to the different treatment methods. The resection rate, operation time, length of stay, medical cost and postoperative complications were compared between the two groups.Results The rate of resection was 100.0% of ESD group and surgical group, the two groups were not statistically significant difference (P＞0.05). The average operative time (89.3 vs 215.4 min, P 0.05), the average hospitalization time (10.5 vs 22.5 D, P 0.05), the average medical cost (versus 1.79 5.93 million yuan, P 0.05),of the ESD group were significantly reduced than the surgery group. There were 1 cases of gastroesophageal reflux, 1 cases of infection, 1 cases of stenosis and 1 cases of bleeding in the ESD group, and the total incidence rate was 10.0% (4/40). There were 7 cases of gastroesophageal reflux, 5 cases of infection, 2 cases of stenosis and 6 cases of bleeding in the ESD group, and the total incidence rate w