内镜下经黏膜下隧道切除术治疗老年胃间质瘤的临床观察

Clinical observation of endoscopic submucous tunnel resection in treatment of gastric stromal tumors in elderly patients

中文关键词: 老年, 胃间质瘤, 内镜下经黏膜下隧道切除术, 并发症, 胃动素, 胃泌素

英文关键词: elderly  gastric stromal tumor  submucosal tunneling endoscopic resection  complication  motilin  gastrin 打印

中文摘要:

      目的 观察内镜下经黏膜下隧道切除术(STER)在老年胃间质瘤的临床应用效果.方法 回顾性收集2020年5月-2023年6月就诊于遂宁市中心医院的118例老年胃间质瘤患者的病历资料,根据不同手术方式分为试验组(n=62)与对照组(n=56).试验组接受STER术式治疗,对照组接受内镜黏膜下层剥离术(ESD)术式治疗.比较2组围手术期情况、肿瘤切除情况、手术应激反应、胃激素水平变化及术后并发症发生情况.结果 与对照组比较,试验组手术时间、术后首次排气时间、住院时间均较短(P＜0.05),且术中出血量更少(P＜0.05);试验组肿瘤全部切除率及完全切除率均高于对照组(P＜0.05);术后3 d,2组去甲肾上腺素(NE)、肾上腺素(E)水平均高于同组术前,超氧化物歧化酶(SOD)水平低于同组术前,但试验组NE、E水平低于对照组,SOD水平高于对照组,差异均有统计学意义(P＜0.05);术后3 d,2组胃动素(MTL)、胃泌素(GAS)水平均低于同组术前(P＜0.05),但试验组MTL、GAS水平高于对照组(P＜0.05);试验组术后并发症总发生率低于对照组(3.23％vs 14.29％,P＜0.05).结论 STER可有利于提高对老年胃间质瘤患者的治疗效果,减轻手术刺激和损伤,促进术后恢复,降低术后并发症发生风险,具有临床应用价值.

英文摘要:

      Objective To observe the clinical effects of endoscopic submucosal tunnel resection(STER)in the treat-ment of gastric stromal tumors in elderly patients.Methods The medical records of 118 elderly patients with gastric stromal tumor admitted to Central Hospital of Suining City from May 2020 to June 2023 were retrospectively collected.They were di-vided into experimental group(n=62)and control group(n=56)according to different operation methods.The experimental group received STER and the control group received endoscopic submucosal dissection(ESD).The perioperative conditions,tumor resection,surgical stress reaction,changes of gastric hormone level and the incidence of postoperative complications were compared between the two groups.Results Compared with the control group,the operation time,first postoperative exhaust time and hospital stay of the experimental group were shorter(P＜0.05),and the intraoperative blood loss was less(P＜0.05).The total resection rate and complete resection rate of tumors in the experimental group were higher than those in the control group(P＜0.05).Three days after surgery,the levels of norepinephrine(NE)and epinephrine(E)in both groups were higher than those in the same group before surgery,and the level of superoxide dismutase(SOD)was lower than that in the same group before surgery.However,the levels of NE and E in the experimental group were lower than those in the control group,and the level of SOD was higher than that in the control group.The differences between the two groups were statistically significant(P＜0.05).Three days after surgery,the levels of motilin(MTL)and gastrin(GAS)in both groups were lower than those in the same group before surgery,while the experimental group were higher than the control group(P＜0.05).The total incidence of postoperative complications in the experimental group was lower than that in the control group(3.23％vs 14.29％,P＜0.05).Conclusion STER is effective in the treatment of elderly patients with gastric stromal tumors.It can re-duce surgical stimulation and injury,promote postoperative recovery,and reduce the risk of postoperative complications.It has certain clinical application value.