CAJ | 학술논문

目的：比较内镜下多环黏膜切除术（EMBM）和内镜下黏膜，剥离术（ESD）治疗食管上皮内瘤变的有效性及安全性。方法85例食管上皮内瘤变患者，其中45例经 EMBM治疗（EMBM治疗组），40例经 ESD治疗（ESD治疗组）。分析相关临床资料，比较两种治疗方法的疗效、并发症、手术时间及医疗费用情况。结果 EMBM治疗组1次切除率为97．8％（44/45），ESD治疗组1次切除率为95．0％（38/40），两组比较差异无统计学意义（P＞0．05）；两组治疗患者于术后第1、3、6、12个月复查胃镜，均未见复发；EMBM治疗组（8．89％，0）出血及穿孔并发症发生率明显低于 ESD治疗组（35．00％，15．00％），P＜0．05；EMBM治疗组[（26．5±14．2）min]手术平均耗时明显低于 ESD治疗组[（65．2±26．1）min]，P＜0．05；ESD治疗组（18000元）住院总费用明显高于 EMBM治疗组（8500元），P＜0．05。结论 EMBM较 ESD操作更简便，并发症少，适宜在基层医院推广应用。
목적：비교내경하다배점막절제술（EMBM）화내경하점막，박리술（ESD）치료식관상피내류변적유효성급안전성。방법85례식관상피내류변환자，기중45례경 EMBM치료（EMBM치료조），40례경 ESD치료（ESD치료조）。분석상관림상자료，비교량충치료방법적료효、병발증、수술시간급의료비용정황。결과 EMBM치료조1차절제솔위97．8％（44/45），ESD치료조1차절제솔위95．0％（38/40），량조비교차이무통계학의의（P＞0．05）；량조치료환자우술후제1、3、6、12개월복사위경，균미견복발；EMBM치료조（8．89％，0）출혈급천공병발증발생솔명현저우 ESD치료조（35．00％，15．00％），P＜0．05；EMBM치료조[（26．5±14．2）min]수술평균모시명현저우 ESD치료조[（65．2±26．1）min]，P＜0．05；ESD치료조（18000원）주원총비용명현고우 EMBM치료조（8500원），P＜0．05。결론 EMBM교 ESD조작경간편，병발증소，괄의재기층의원추엄응용。
Objective To compare the effectiveness and safety of endoscopic polycyclic mucosal resection(EMBM)and endo-scopic submucosal dissection(ESD)in the treatment of esophageal intraepithelial neoplasia.Methods 85 cases of esophageal intra-epithelial neoplasia patients,including 45 cases treated by EMBM and 40 cases treated by ESD.To compare the efficacy,complica-tions,operation time,and medical fees of the two treatment methods by analysis of relevant clinical data.Results Once resection rate of the EMBM treatment group was 97.8%(44/45),and 95.0%(38/40)for the ESD treatment group,there is no significant difference between the two groups(P>0.05);Endoscopy of both treated patients in the postoperative 1,3,6,and 12 months showed no recurrence;The complications incidence of bleeding and perforation of the EMBM treated group(8.89%,0)was significantly lower than that of the ESD treated group(35.00%,15.00%),P<0.05;The average operation time of the EMBM treated group [(26.5±14.2)min]was significantly lower than that of the ESD treated group[(65.2±26.1)min],P<0.05;The total cost of hospitalization of the ESD treated group(18 000 yuan)was significantly higher than the EMBM treated group(8 500 yuan),P<0.05.Conclusion Compared with ESD,EMBM has an easier operation,less complications and patient consuming,and it is suitable for application in primary hospitals.