隧道法内镜下粘膜下剥离术治疗食道粘膜下肿瘤的临床价值

摘要 目的：探讨隧道法内镜下粘膜下剥离术治疗食道粘膜下肿瘤的临床价值。方法：2014年2月至2017年9月选择在本院诊治的食道粘膜下肿瘤患者172例,根据手术方法的不同分为观察组100例与对照组72例。观察组给予隧道法内镜下粘膜下剥离术,对照组给予内镜粘膜下剥离术治疗,记录与随访两组的预后情况。结果：两组手术时间对比无差异(P>0.05),观察组的术中出血量、术后禁食天数与术后住院时间显著少于（短于）对照组(P<0.05)。观察组术后3 d的并发症发生率为3.0 %,显著低于对照组的15.3 %(P<0.05)。观察组术后1 d与术后14 d的血清IL-2、sIL-2R含量都显著低于对照组(P<0.05)。随访2年,观察组的1年与2年复发率分别为2.0 %和6.0 %,显著低于对照组的8.3 %和15.3 %(P<0.05)。结论：隧道法内镜下粘膜下剥离术治疗食道粘膜下肿瘤能减少创伤,减少并发症的发生,降低复发率,并促进患者免疫功能的恢复。

Clinical Values of Endoscopic Submucosal Dissection under Tunneling for Treatment of Submucosal Tumors

ABSTRACT Objective: To investigate the clinical value of Endoscopic submucosal dissection under tunneling in the treatment of Submucosal Tumors. Methods: From February 2014 to September 2017, 172 patients with Submucosal Tumors diagnosed and treated in our hospital were selected as subjects and were divided into the 100 patients in the observation group and 72 patients in the control group accorded to the different surgical methods. The observation group were given Endoscopic submucosal dissection under tunneling, and the control group were treated with Endoscopic Submucosal Dissection. The prognosis of the two groups were recorded and followed up. Results: There were no significant difference in the operation time compared between the two groups(P>0.05). The intraoperative blood loss, postoperative fasting days and postoperative hospital stay in the observation group were significantly less than in the control group (P<0.05). The postoperative 3 d of incidences were 3.0 % in the observation group, which were significantly lower than that in the control group of 15.3 %(P<0.05). The postoperative 1 d and 14 d levels of serum IL-2 and sIL-2R in the observation group were significantly lower than those in the control group(P<0.05). After 2 years of followed-up, the 1-year and 2-year recurrence rates of the observation group were 2.0 % and 6.0 %, respectively, which were significantly lower than the 8.3 % and 15.3 % of the control group(P<0.05). Conclusion: Endoscopic submucosal dissection with tunneling for the treatment of submucosal tumors of the esophagus can reduce trauma, reduce the incidence of complications, reduce the recurrence rate of patients, and promote the recovery of immune function.