王桢桢 邓奇烽 麦国 柯达

【摘要】 目的：对比在治疗消化道早癌或癌前病变中應用内镜黏膜下剥离术与传统外科手术的效果。方法：选取笔者所在医院2018年1月-

2019年6月收治的90例消化道早癌及癌前病变患者作为研究对象，根据手术方法的不同分为两组，对照组行传统外科手术，观察组行内镜黏膜下剥离术，对比两组效果。结果：观察组手术时间、住院时间均短于对照组，术中出血量少于对照组，差异均有统计学意义（P<0.05）。观察组并发症发生率为4.4%，低于对照组的17.8%，差异有统计学意义（P<0.05）。观察组整块完整切除率（100%）高于对照组（88.9%），治愈性切除率（97.8%）高于对照组（84.4%），差异均有统计学意义（P<0.05）。结论：与传统外科手术相比，内镜黏膜下剥离术治疗消化道早癌或癌前病变的效果更加显著，值得推广。

【关键词】 消化道早癌 内镜黏膜下剥离术 癌前病变 传统外科手术 效果

doi：10.14033/j.cnki.cfmr.2020.19.006 文献标识码 B 文章编号 1674-6805（2020）19-00-03

Application of Endoscopic Submucous Dissection and Conventional Surgery in Patients with Early Gastrointestinal Cancer or Precancerous Lesions/WANG Zhenzhen， DENG Qifeng， MAI Guo， KE Da. //Chinese and Foreign Medical Research， 2020， 18（19）： -18

[Abstract] Objective： To compare the efficacy of endoscopic submucosal dissection with conventional surgery in the treatment of early and precancerous lesions of the digestive tract. Method： A total of 90 patients with early gastrointestinal cancer and precancerous lesions treated in our hospital from January 2018 to June 2019 were selected as the research objects， and were divided into two groups according to the different surgical methods， the control group underwent conventional surgery， the observation group underwent endoscopic submucosal dissection， and the results of the two groups were compared. Result： The operative time and hospital stay in the observation group were shorter than those in the control group， and the intraoperative blood loss was less than that in the control group， the differences were statistically significant （P<0.05）. The incidence of complications in the observation group was 4.4%， lower than 17.8% in the control group， the difference was statistically significant （P<0.05）. The total cut rate in the observation group （100%） was higher than that in the control group （88.9%）， and the healing cut rate （97.8%） was higher than that in the control group （84.4%）， the differences were statistically significant （P<0.05）. Conclusion： Compared with conventional surgery， endoscopic submucous dissection is more effective in the treatment of early gastrointestinal cancer or precancerous lesions， which is worth popularizing.

[Key words] Early cancer of digestive tract Endoscopic submucosal dissection Precancerous lesions Conventional surgery Effect

First-authors address： Maoming City Peoples Hospital， Maoming 525000， China

近年来，随着人们生活方式、饮食习惯的不断变化，消化道疾病的发病率也越来越高，而其中就有很大一部分消化道早癌及癌前病变患者[1]。常见的消化道早癌包括早期食管癌、早期胃癌、早期结肠癌等，这对于患者的生命健康及生活质量都有着严重的威胁，必须给予及时有效的治疗。手术是治疗消化道早癌及癌前病变的重要手段，其在改善患者临床症状，促进患者恢复健康方面发挥着重要的作用[2]。随着医疗技术的不断提升，治疗消化道早癌及癌前病变的手术方法越来越多。内镜黏膜下剥离术就是治疗消化道早癌的常用方法，相比传统外科手术治疗而言，其具有创伤小、恢复快的特点，所以在临床上有着广泛的应用[3]。为了进一步证实内镜黏膜下剥离术的治疗效果，本研究就将其与传统外科手术治疗进行对比分析，详细如下。……