内镜下改良乳头切除法在十二指肠乳头腺瘤切除术中的临床价值分析

摘要

目的:分析内镜下改良乳头切除法在十二指肠乳头腺瘤切除术的临床价值.方法:选择在医院接受诊治的40例十二指肠乳头腺瘤患者,按随机数表法将其分为观察组和对照组,每组20例.对照组采用常规乳头腺瘤切除术,观察组采用改良内镜下乳头切除术.分析比较两组患者的切除率及支架的置入情况;比较两组患者的并发症发生率及术后的随访情况.结果:观察组的完全切除率为95%,对照组为90%,两组相比无明显差异,但观察组的整块切除率(85%)与对照组(55%)相比,差异有统计学意义(x2=4.28,P<0.05).两组患者置入支架的情况相比无统计学意义(x2=0.36,P>0.05).术后3个月内近期并发症发生情况,两组患者的近期并发症发生率比较有明显差异(x2=6.14,P<0.05).术后超过3个月远期并发症发生情况,两组患者的并发率相比无明显差异(x2=0.36,P>0.05).随访一年间,观察组患者的复发率为10.34%,与对照组(14.29%)相比,差异无统计学意义(x2=0.17,P>0.05).结论:改良的内镜下乳头切除可以提高整块切除率,降低患者的并发症发生率,复发率也较低,临床上可行性较高且具有治疗优势.%Objective: To analyze the clinical value of modified endoscopic nipple resection in duodenal papillary adenoma resection Methods: 40 patients with duodenal papillary adenoma were randomly divided into observation group (20 cases) and control group (20 cases)according to the random number table. The patients of control group were treated by conventional resection of papillary adenoma, while the patients of observation group were treated by modified endoscopic nipple resection. The resection rate and the implantation of stent between the two groups were compared. Besides, the occurrence rate of complication and postoperative follow-up between the two groups also were compared. Results: The complete resection rate of observation group (95.00%) was not significant difference with that of control group (90.00%), while en bloc resection rate of observation group (85.00%) significant higher than that of control group (55.00%) (x2=4.28, P<0.05).There was not statistically significant difference between the two groups about the implantation of stent (x2=0.36, P>0.05). In postoperative three months, the difference of recently complication between the two groups was significant (x2=6.14, P<0.05). While the difference of long-term complication between the two groups was no significant (x2=0.36, P>0.05) in more than postoperative three months. After the follow-up of one year, the recurrence rate of observation group (10.34%) was no significant with that of control group (14.29%)(x2=0.17, P>0.05). Conclusion: The modified endoscopic nipple resection can enhance the en bloc resection rate, and reduce the incidence of complications and the recurrence rate. Besides, it has many dominances including higher feasibility in clinical practices. Therefore, its promotion is worthy.