内镜黏膜下剥离术治疗胃黏膜高级别上皮内瘤变的临床效果及术后复发高危因素被引量：2

Clinical effect of endoscopic submucosal dissection in the treatment of gastric mucosal high-grade intraepithelial neoplasia and high risk factors for postoperative recurrence

在线阅读下载PDF

导出

摘要目的探讨内镜黏膜下剥离术(ESD)治疗胃黏膜高级别上皮内瘤变(HGIN)临床效果及术后复发高危因素。方法选取2016年1月至2021年3月萍乡市人民医院消化内科收治的25例HGIN患者作为研究对象,均行ESD治疗,观察术后临床疗效,并分析影响术后复发的高危因素。结果25例HGIN患者术后并发症发生率为12.00%(3/25),整块切除率为92.00%(23/25),完整切除率为92.00%(23/25),治愈性切除率为92.00%(23/25)。术后随访1年,2例失访,23例患者术后复发率为8.69%(2/23)。单因素分析结果显示,ESD术后复发与病变层次、伴溃疡形成有关,差异有统计学意义(P<0.05)。logistic回归模型进行多因素分析结果显示,病变位于黏膜下层(β=1.661,OR=5.265,95%CI=1.408~19.689)、伴溃疡形成(β=0.785,OR=2.192,95%CI=1.232~3.901)均为影响ESD术后肿瘤复发的独立危险因素(P<0.05)。结论ESD治疗胃黏膜HGIN临床疗效良好,病变位于黏膜下层、伴溃疡形成为患者术后复发的高危因素,临床应予以重视。 Objective To investigate the clinical effect of endoscopic submucosal dissection(ESD)in the treatment of gastric mucosal high-grade intraepithelial neoplasia(HGIN),and the risk factors for postoperative recurrence.Methods A total of 25 patients with HGIN admitted to the department of gastroenterology in the hospital and treated with ESD from January 2016 to March 2021 were selected as the research objects.The clinical effect was observed,and the high-risk factors for postoperative recurrence were analyzed.Results The incidence of postoperative complications,en bloc resection rate,complete resection rate and curative resection rate in this study were 12.00%(3/25),92.00%(23/25),92.00%(23/25)and 92.00%(23/25),respectively.Two patients were lost to follow-up,and the postoperative recurrence rate was 8.69%(2/23).Univariate analysis showed that recurrence after ESD was related to lesion level and ulcer formation,and the difference was statistically significant(P<0.05).Logistic regression analysis showed lesion located in submucosa(β=1.661,OR=5.265,95%CI=1.408-19.689)and ulceration(β=0.785,OR=2.192,95%CI=1.232-3.901)were independent risk factors for tumor recurrence after ESD(P<0.05).Conclusion ESD is effective in the treatment of gastric mucosal HGIN.Lesion located in submucosa,and ulceration are high-risk factors for postoperative recurrence,clinical attention should be paid.

作者赖丽霞朱勇美李兴 LAI Lixia;ZHU Yongmei;LI Xing(Department of Gastroenterology,Pingxiang City People′s Hospital,Jiangxi Province,Pingxiang337000,China)

机构地区江西省萍乡市人民医院消化内科

出处《中国当代医药》 CAS 2022年第30期46-49,共4页 China Modern Medicine

基金江西省卫生健康委科技计划项目(20202058)。

关键词胃黏膜病变内镜黏膜下剥离术疗效影响因素 Gastric mucosal lesion Endoscopic submucosal dissection Curative effect Influencing factor

分类号 R735 [医药卫生—肿瘤]

作者简介赖丽霞(1977-),女,江西萍乡人,副主任医师。