摘要
目的:探讨内镜黏膜下隧道肿瘤切除术(STER)与内镜黏膜下剥离术(ESD)治疗对上消化道黏膜下肿瘤患者的创面愈合效果及术后并发症的影响。方法:将笔者所在医院2015年4月-2017年8月收治的88例确诊为上消化道黏膜下肿瘤患者作为研究对象,并通过随机数字表法将其分为对照组与观察组,每组44例。对照组采取ESD治疗,观察组应用STER治疗,术后随访观察并分析两组患者的创面愈合、术后疗效及术后并发症的情况。结果:观察组患者的创面长径、术后进食时间、总住院时间均优于对照组,差异均有统计学意义(P<0.05),两组病灶最大径比较差异无统计学意义(P>0.05)。术后,观察组有1例(2.27%)轻度颈部皮下气肿,无出血和感染情况,1例(2.27%)穿孔;对照组有3例(6.82%)轻度颈部皮下气肿,3例(6.82%)出血,2例(4.54%)感染,3例(6.82%)穿孔,观察组术后轻度颈部皮下气肿、感染、出血及穿孔等并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:STER和ESD均可用于上消化道黏膜下肿瘤的治疗,与ESD相比,STER的术中出血量更少,并发症更少,促进患者早日康复,属于治疗上消化道黏膜下肿瘤的主要方法,且创面愈合效果显著。
Objective:To investigate the effect of submucosal tunneling endoscopic resection(STER) and endoscopic submucosal dissection(ESD) on wound healing and postoperative complications in patients with submucosal tumor of upper gastrointestinal tract.Method:A total of 88 patients with submucosal tumor of upper gastrointestinal tract who were admitted to the hospital from April 2015 to August 2017 were randomly divided into the control group(n=44) and the observation group(n=44).The patients in the control group were treated with ESD,and the patients in the observation group were treated with STER.The wound healing,postoperative efficacy and postoperative complications were observed and analyzed in the two groups after operation.Result:The length of wound,postoperative feeding time and total hospitalization time of the patients in the observation group were better than those in the control group,the differences were statistically significant(P<0.05),but there was no significant difference between the two groups in the maximum diameter of the lesion(P>0.05).In the observation group,there was 1 case of mild subcutaneous emphysema of the neck accounted for 2.27%,no bleeding and infection,and 1 case of perforation accounted for 2.27% after operation.In the control group,there were 3 cases of mild subcutaneous emphysema of the neck accounted for 6.82%,3 cases of bleeding accounted for 6.82%,2 cases of infection accounted for 4.54% and 3 cases of perforation accounted for 6.82%.The incidence of mild subcutaneous emphysema of the neck,infection,bleeding and perforation in the observation group was lower than that in the control group after operation,the difference was statistically significant(P<0.05).Conclusion:Both STER and ESD can be used in the treatment of submucosal tumors of upper gastrointestinal tract.Compared with ESD,the intraoperative bleeding volume of STER is less and the complications are less,which can promote the early recovery of the patients.It is the main method for the treatment of submucosal tumor of upper gastrointestinal tract.And the wound healing effect is remarkable.
引文
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