摘要
目的对比研究内镜黏膜下剥离术（ESD）与传统外科手术治疗消化道早癌或癌前病变的效价比。方法选择2006年11月至2012年9月确诊的866位消化道早癌或癌前病变的住院患者，对其病历资料进行回顾性分析，根据治疗方法不同分为ESD组及传统外科手术组。记录和对比分析两组患者的基本信息、卫生经济学资料以及治疗情况。结果ESD组共607例患者，外科组共259例患者；两组病变的完全切除率相当（93．1％比93．0％，P〉0．05）；ESD组和外科组的平均住院天数、住院费用分别为13．01d比18．88d（P〈0．05），22932．17元比57993．88元（P〈0．05）；ESD组中共有22例（1．98％）患者出现术中及术后出血，17例（2．80％）患者出现穿孔；传统外科手术组中，共有8例（3．01％）出血、3例（1．16％）穿孔。两组出血及穿孔率差异无统计学意义。结论ESD术及传统外科手术均为治疗消化道早癌或癌前病变的有效手段，与传统外科手术治疗相比，ESD术在平均住院日、住院费用方面具有明显优势。
Objective To compare the cost-effectiveness between endoscopic submucosal dissection （ESD） procedure and traditional surgery for the treatment of early gastrointestinal cancer or precancerous lesions. Methods A total of 866 early GI cancer/precancerous patients who had been admitted to Chinese PLA General hospital and Qilu hospital were included in this study. The medical records of all 866 patients were reviewed. Patients were divided into ESD group and traditional surgery group. Parameters of each pa- tient, such as time of hospitalization, total treatment cost and incidence of complications, were documented and later compared in detail. Results A total of 607 patients were included in the ESD group and 259 in the traditional surgery group. There was no statistical difference in complete resection rate between the two groups （93.1% vs 93.0%, P 〉 0. 05）. The ESD group showed a shorter mean hospitalization time （d） （ 13.01 vs 18.88, P 〈0. 05） and lower treatment cost （RMB） than the traditional surgery group （22932. 17 vs 57993.88, P 〈 0. 05 ）. The incidence of hemorrhage and perforation for each group were 3.63% and 3.10% respectively, which were not significantly different （ 1.98% vs 3.01%, P 〉 0.05 ; 2. 80% vs 1.16%, P 〉 0.05）. Conclusion ESD and surgery are both effective for early gastrointestinal cancer/pre- cancerous lesions therapy, but ESD procedure is superior to surgery in terms of hospitalization time and expe- diture.
出处
《中华消化内镜杂志》
2013年第1期15-17,共3页
Chinese Journal of Digestive Endoscopy
关键词
消化系统肿瘤
癌前状态
内镜黏膜下剥离术
传统外科手术
费用效益分析
Digestive system neoplasms
Precancerous conditions
Endoscopic submucosal dis- section
Traditional surgery
Cost-Benefit analysis
