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1、单纯内镜黏膜下剥离术与综合微创手术治疗胃肠道间质瘤的临床比较研究-第 1 页，共 4 页精品p d f 资料 可编辑资料-摘要 目的 对比研究单纯内镜黏膜下剥离术与综合微创手术在治疗胃肠道间质瘤过程中的临床效果。方法 本文将 2016年 1 月-2017 年 1 月期间在我院接受胃肠道间质瘤治疗的128例患者作为研究的对象，按照随机数字表法将患者分为接受综合微创手术治疗的实验组和接受单纯内镜黏膜下剥离术治疗的对照组，每组各有患者64 例。结果 与对照组患者相比实验组患者在治疗总有效率以及肿瘤切除率、术中穿孔率、平均住院时间和平均手术费用等情况上均具有明显的差异，具有统计学意义（p0.05)。-
2、第 2 页，共 4 页精品p d f 资料 可编辑资料-文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6
3、Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6
4、N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6
5、Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6
6、N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6
7、Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6
8、N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q71.2 治疗方法1.2.1给予实验组患者综合微创手术治疗，常规进镜明确病灶的部位，并在套扎之前运用高频电凝在病变的顶端做好标志，退出内镜后对套扎器进行安装，并再次进入内镜，对病灶位置进行明确，对准病灶之后进行持续负压吸引，使黏膜下的肿物侵入到透明帽内，之后继续释放橡皮圈套扎黏膜下的肿物，运用针状刀进行黏
9、膜下剥离，之后将完整的肿块送去病理活检。1.2.2对照组患者给予单纯内镜黏膜下剥离术治疗，运用针形切开刀与于隆起的病灶边缘进行电凝标记，并在标记点的外侧注射含有1:10000 肾上腺素的生理盐水，沿着标记点切开黏膜，显露固有基层病灶后沿着病灶的边缘进行剥离，玻璃结束时加用圈套器圈套病变完成电切，并将肿块送去病理活检。1.3 观察指标对本次实验研究中两组治疗总有效率以及肿瘤切除率、术中穿孔率、住院时间、治疗费用等基本手术情况均细致的观察和记录，为实验统计和分析提供数据基础以及保证。疗效评价标准：患者治疗后临床症状和体征均消失，术后无肿瘤残留和复发情况为痊愈；患者治疗后主要的临床症状和体征消失为有
10、效；患者治疗后临床症状与体征均无明显的变化为无效，治疗总有效率的计算方法为痊愈例数与有效例数之和与总例数的比值乘以100%。1.4 统计学分析运用统计学软件SPSS19.0完成实验中所有相关数据的处理和分析，采用百分比（%）以及均数标准差（XS）对计数资料进行表示，运用卡方（X2）对计量资料进行分析，采用独立样 t 对组间构成比进行检验，将P0.05 作为表示实验数据结果间差异具有统计学意义的标准。2 结果2.1 与对照组 64 例患者相比实验组64 例患者在治疗总有效率上存在明显的优势，差异具有统计学意义（p0.05）。详见表 1。表 1 实验组与对照组患者手术治疗情况分析比较组别例数痊愈有
11、效无效有效率实验组643230296.9%-第 3 页，共 4 页精品p d f 资料 可编辑资料-文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3
12、H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 Z
13、K6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3
14、H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 Z
15、K6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3
16、H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 Z
17、K6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7对照组642332985.9%注：实验组患者手术治疗总有效率与对照组患者比较，p0.05。2.2 与对照组 64 例患者相比实验组64 例患者在，肿瘤切除率、术中穿孔率、平均住院时间和平均手术费用等情况上均具有明显的差异，具有统计学意义（p0.05）。详见表
18、2。表 2 对比分析实验组与对照组患者基本手术情况组别例数肿瘤切除率术中穿孔率平均住院时间（天）平均治疗费用（元）实验组64100.0%（64/64）1.4%（1/74）3.141.043325.6233.5对照组6482.8%（53/64）10.8%（8/74）4.581.233945.9265.5注：实验组患者手术基本情况与对照组患者比较，p0.05。3 讨论在为胃肠道间质瘤患者提供治疗的过程中首次治疗以及完整的切除肿瘤是非常重要的，科学、合理的首次治疗方案，可以明显提高患者的生存质量以及生存时间，因此，这一疾病的首次治疗方法选择至关重要，可以有效的避免日后无休止的被动治疗，在这样的情况下
19、就应该分析更好的胃肠道间质瘤手术治疗方案3-4。目前，临床上胃肠道间质瘤的治疗方法有很多，较为常见的两种分别为单纯内镜下剥离术和内镜下套扎术联合内镜黏膜下剥离术这一综合微创手术治疗方案。前一治疗方法属于局部微创手术，可以一次性全部切除病灶，但是其容易出现胃穿孔和出血等并发症，依然存在复发的可能，而内镜下套扎术联合内镜黏膜下剥离术这一治疗方案弥补了单纯内镜下剥离术存在的不足，有效的改善了患者的预后，提高了手术的质量并有效的促进了患者的康复，取得了显著的治疗效果5-6。在本次试验研究中，与对照组患者相比实验组患者在治疗效果以及肿瘤切除率、术中穿孔率、平均住院时间和平均手术费用等情况上均具有明显的差
20、异，具有统计学意义（p0.05）。综上所述，在为胃肠道间质瘤患者提供治疗服务的过程中综合微创手术治疗提高了手术的有效率和质量，提高了肿瘤的切除率，减少了术中穿孔，降低了治疗费用，同时也有效的缩短了患者的住院时间，与单纯内镜下剥离术相比具有更为确切的效果，值得予以临床推广和运用。-第 4 页，共 4 页精品p d f 资料 可编辑资料-文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6
21、N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6
22、Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6
23、N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6
24、Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6
25、N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7文档编码:CD3Y3H6N6G6 HW3E5V3E9I2 ZK6Q8A7B6Q7