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目的:对EMR和ESD两种疗法用于胃食管早癌及癌前病变治疗中的疗效进行比较,寻求理想的疗法用于临床推广。方法:选取2010年3月-2013年3月间采用内镜下治疗胃食管早癌及癌前病变患者48例为研究对象,采用随机数字表法将其分为观察和对照组,分别采用ESD和EMR两种疗法予以治疗。治疗后就病灶大小,术中出血率,一次切除率,并发症及随访1年的复发率等数据进行组间比较及数据分析。结果:观察组平均病灶直径为(1.72±0.22)cm,术中出血率12.5%优于对照组,且具有显著差异性(P<0.05);在病灶一次切除率,穿孔率等数据的比较中,观察组略逊于对照组,但无显著差异性(P>0.05);观察组随访1年复发率为16.7%优于对照组29.2%的复发率,且具有显著差异性(P<0.05)。结论:ESD用于胃食管早癌及癌前病变治疗中具有切除病灶大,术中出血率低,复发率低等优势,但其一次清除率及穿孔率还需进一步提升。
OBJECTIVE: To compare the efficacy of EMR and ESD in the treatment of gastroesophageal cancer and precancerous lesions, and to find the ideal therapy for clinical promotion. Methods: Forty-eight patients with gastroesophageal precancerous lesions and precancerous lesions undergoing endoscopy were selected from March 2010 to March 2013. The patients were divided into observation and control groups by random number table method, And EMR two kinds of treatment to be treated. After treatment, the size of the lesion, intraoperative bleeding rate, a resection rate, complications and follow-up of 1 year relapse rate data were compared between groups and data analysis. Results: The mean lesion diameter of the observation group was (1.72 ± 0.22) cm and the rate of bleeding was 12.5%, which was significantly higher than that of the control group (P <0.05). In comparing the data of resection rate and perforation rate (P> 0.05). The recurrence rate of follow-up one year was 16.7% in the observation group, which was significantly lower than that of the control group (29.2%), and there was significant difference (P <0.05) . Conclusion: ESD has the advantages of large excision lesions, low intraoperative bleeding rate and low recurrence rate in the treatment of gastroesophageal precancerous lesions and precancerous lesions. However, its clearance rate and perforation rate need to be further improved.