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目的探讨内镜下切除术联合皮圈结扎闭合术治疗胃固有肌层肿瘤患者的临床效果。方法选取2013年1月至2014年2月沈阳市苏家屯区中心医院收治的110例胃固有肌层肿瘤患者作为研究对象,结合患者入院时间先后分为观察组与对照组,各55例。观察组患者采用内镜下切除术联合皮圈结扎闭合术进行治疗,对照组患者则行内镜下黏膜结扎剥离术,比较两组患者手术持续时间、住院时间、切除标本直径、术后并发症发生率、随访期间复发情况以及手术应激指标变化情况。结果术中,观察组患者的肾上腺素(E)、去甲肾上腺素(NE)、血管紧张素Ⅱ(ATⅡ)水平均明显低于对照组,差异均有统计学意义(均P<0.05);观察组患者手术持续时间及住院时间均明显短于对照组,术中切除标本直径明显大于对照组,差异均有统计学意义(均P<0.05);观察组患者术后1年、2年复发率及康复过程中并发症发生率均明显低于对照组,差异均有统计学意义(均P<0.05)。结论内镜下切除术联合皮圈结扎闭合术治疗胃固有肌层肿瘤相较于内镜下黏膜结扎剥离术临床效果更优,可有效促使患者早日康复,术中应激反应更加平缓,复发率及并发症发生率均较低。
Objective To investigate the clinical effect of endoscopic resection combined with aponeurotic ligation in the treatment of patients with gastric muscular lamina propria. Methods From January 2013 to February 2014, 110 cases of gastric musculoskeletal cancer patients admitted to Sujiatun Central Hospital of Shenyang were enrolled in this study. The patients were divided into observation group and control group with 55 cases in each group. The patients in the observation group were treated with endoscopic resection combined with aprons ligation and closure. The patients in the control group underwent endoscopic mucosal ligation and dissection. The duration of operation, length of hospital stay, diameter of resected specimens, postoperative complications Incidence, recurrence during follow-up and changes in surgical stress indicators. Results During the operation, the levels of epinephrine (E), norepinephrine (NE) and angiotensin Ⅱ (AT Ⅱ) in the observation group were significantly lower than those in the control group (all P <0.05). The duration of surgery and hospital stay in the observation group were significantly shorter than those in the control group. The diameter of the resected specimens in the observation group was significantly larger than that in the control group (all P <0.05). The patients in the observation group relapsed 1 year and 2 years after operation The rates of complications and complications in the process of rehabilitation were significantly lower than those in the control group (all P <0.05). Conclusion Endoscopic resection combined with aponeurosis treatment of gastric muscular lamina propria tumors compared with endoscopic mucosal ligation and stripping better clinical results, which can effectively promote the early recovery of patients, intraoperative stress response is more gentle, the recurrence rate And the incidence of complications are lower.