探讨内镜下黏膜剥离术（ESD）治疗早期胃癌的疗效。

选取2017年2月至2020年1月天津医科大学第二医院收治的早期胃癌患者200例，其中100例患者行内镜黏膜切除术（EMR）治疗（对照组），余100例患者行ESD治疗（观察组）。观察两组患者的病变切除情况、手术指标、胃蛋白酶原（PG）水平及预后情况。计量资料的比较采用t检验，计数资料的比较采用χ²检验。

观察组患者病灶切除面积、胃癌大块切除率、胃癌完全切除率、胃癌治愈性切除率均明显高于对照组（t=25.610，χ²=4.301、4.247、4.046，P<0.05），且术中出血量更小、住院时间更短（t=17.663、11.330，P<0.05）。术后7 d，与对照组相比，观察组患者PGⅠ、PGⅠ/PGⅡ均更高（t=5.056、9.951，P<0.05），PGⅡ更低（t=7.455，P<0.05）。观察组并发症总发生率低于对照组（χ²=3.988，P<0.05）。

与EMR相比，ESD治疗早期胃癌可更好地切除病变组织，减少出血量，改善胃蛋白酶原水平，缩短住院时间，减少并发症的发生。

To study the therapeutic effects of endoscopic submucosal dissection (ESD) in the treatment of early gastric cancer.

200 patients with early gastric cancer admitted to the Second Hospital of Tianjin Medical University from February, 2017 to January, 2020 were randomly divided into control group (100 cases) and study group (100 cases). The control group underwent endoscopic mucosal resection (EMR), while the study group underwent ESD. Observe the lesion resection status, surgical indicators, pepsinogen (PG) levels, and prognosis of two groups using t test or χ² test.

The lesion resection area, gastric cancer mass resection rate, gastric cancer complete resection rate, and gastric cancer curative resection rate of the study group were all higher than those of the control group (t=25.610; χ²=4.301, 4.247 and 4.046; P < 0.05). Compared with the control group, the intraoperative bleeding volume was lower (t=17.663, P < 0.05) and the hospital stay was shorter (t=11.330, P < 0.05) in the study group. 7 days after surgery, compared with the control group, the study group had higher PGI and PGI/PGII (t=5.056 and 9.951, P < 0.05), and lower PGII (t=7.455, P < 0.05). The overall incidence of complications in the study group was lower than that in the control group (χ²=3.988, P < 0.05).

Compared with EMR, ESD treatment for early gastric cancer can better remove tumor tissue, reduce bleeding, improve PG levels, shorten hospital stay, and reduce the incidence of complications.