内镜黏膜下切除术治疗消化道肿瘤性病变的临床分析

王亚军，王让兰

（陕西省宝鸡市岐山县医院消化内科，陕西 宝鸡，722400）

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摘要：

目的 分析内镜黏膜下切除术（EMR）治疗消化道肿瘤性病变的临床疗效。方法 选取我院应用内镜下黏膜切除术进行 病变切除治疗的62 例消化道肿瘤性病变患者作为研究对象，分析患者术后疗效及并发症发生情况。结果 108个病灶均完全切除，治疗成功率为100%，其中105个病灶均为一次性切除，所切除病灶范围为0.4 ~6.0 cm。并发症分析：术中创面少量出血6例，直肠早期腺癌术后迟发出血1 例，经及时处理后均有效止血；术后无管腔狭窄、穿孔、局限性腹膜炎等严重并发症。镜下观察：32个病灶形态为宽基息肉，25个病灶形态为有蒂息肉，16个病灶形态为亚蒂息肉，10个病灶形态为结节样息肉样隆起，8个病灶形态结节样息肉样隆起，5个病灶形态半圆形/类圆形膜隆起，11个扁平型病变，1个侧向发育型肿瘤。随访1年，完全切除病灶者复查原切除部位未见病变残留或复发。结论 内镜下黏膜切除术是一种安全微创的内镜治疗手段，可以 有效、完整切除消化道肿瘤病变，并发症少，安全性好，值得临床推广。

关键词：消化道肿瘤性病变；内镜下黏膜切除术；并发症

中图分类号：R735文献标志码：A文章编号：2096-1413(2016)27-0093-02

Clinical analysis of endoscopic mucosal resection for gastrointestinal cancer lesions
WANG Ya-jun, WANG Rang-lan
(Department of Gastroenterology, Qishan County Hospital, Baoji 722400, China)

ABSTRACT: Objective To analyze the clinical effect of endoscopic mucosal resection (EMR) for gastrointestinal cancer lesions. Methods Sixty -two patients with gastrointestinal cancer lesions in our hospital were treated with endoscopic mucosal resection and selected as study objects. The clinical curative effect and complications of the patients after the operation were analyzed. Results One hundred and eight lesions were completely removed, the success rate of the treatment was 100%, in which 105 lesions were removed at the first surgery, the range of the excised lesions were 0.4-6.0 cm. The analysis of complications: there were 6 cases with a little intraoperative bleeding at the surface of the wound, 1 case with rectal adenocarcinoma early postoperative delayed bleeding, all the patients were treated with effective hemostasis in time. After the operation, there were no serious complications such as stenosis, perforation, localized peritonitis, etc. the endoscopic observation showed that the shape of 32 lesions was wide polyps, the shape of 25 lesions was pedunculated polyp morphology, the shape of 16 lesions was rebagliati polyps, the shape of 10 lesions was nodular polypoid bulge, the shape of 8 lesions was nodular polypoid bulge, the shape of 5 lesions was semi-circular/oval film bulge, the shape of 11 lesions were flat, 1 case was lateral developmental tumors. After one year followed up, the patients who had complete resection of the lesion had no residual or recurrence. Conclusion Endoscopic mucosa resection is a safe minimally invasive therapy, which can remove the digestive tract tumor lesions effectively with less complications, it has better security and is worthy of being widely applied in clinic.
KEYWORDS: gastrointestinal cancer lesions; endoscopic mucosal resection; complications

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