热活检钳联合黏膜下注射切除结直肠微小息肉临床效果观察

doi:10.6040/j.issn.1671-7554.0.2018.011

摘要/Abstract

摘要： 目的探讨经内镜用热活检钳切除结直肠微小息肉的临床效果。方法选择已行内镜下治疗的结直肠息肉患者320例作为研究对象,其中发现结直肠微小息肉(直径<10 mm)929枚,根据患者息肉切除的方法分为两组,热活检钳组183例(562枚息肉),氩离子凝固术组137例(367枚息肉)。比较两种治疗方法用于切除直径<10 mm的结直肠微小息肉的临床疗效。结果热活检钳组治疗直径≤6 mm的息肉切除率为100%,治疗直径<10 mm的息肉有效率为97.5%,氩离子凝固术治疗直径<10 mm的结直肠息肉有效率为86.6%;术后并发症:两组无1例术后穿孔,热活检钳组仅1例术后第3天发生出血,有2例术后轻微腹部胀痛,术后并发症发生率1.6%。氩离子凝固术组有3例出现术后出血,有5例术后轻微腹部胀痛,术后并发症发生率5.8%。结论内镜下通过热活检钳切除结直肠直径≤6 mm的微小息肉与传统的氩离子凝固术等方法相比,操作简单、疗效好、并发症少。

关键词: 结直肠, 微小息肉, 热活检钳, 临床效果

Abstract: Objective To investigate the clinical efficacy of endoscopic resection of small colorectal polyps with thermal biopsy forceps. Methods A total of 390 patients with colorectal polyps treated during Jan. 2015 and May 2017 were selected, with 929 micro-polyps(diameter 1-10 mm)involved. The patients were divided into 2 groups according to different methods of polypectomy: thermal biopsy forceps group(n=183, 562 polyps), and argon plasma coagulation group(n=137, 367 polyps). The clinical efficacy of the 2 groups were compared. Results In the thermal biopsy forceps group, the removal rate of polyps ≤6 mm was 100%, and the effective rate for polyps <10 mm was 97.5%. In contrast, in the argon plasma coagulation group, the effective rate for polyps <10 mm was 86.6%. No perforation developed in either group. In the thermal biopsy forceps group, bleeding occurred in 1 case and slight abdominal pain in 2 cases. The incidence of postoperative complications was 1.6%. In the argon plasma coagulation group, bleeding occurred in 3 cases and abdominal pain in 5 cases. The incidence of postoperative complications was 5.8%. Conclusion Compared with traditional argon plasma coagulation, endoscopic thermal biopsy forceps is simple and effective for the resection of colorectal polyps ≤6 mm. It is worthy of wide clinical application.

Key words: Colorectum, Small polyp, Thermal biopsy forceps, Clinical efficacy

中图分类号:

R735.3

韦明勇,任慧玲,吴军,彭薛,谢汶甫,张敏. 热活检钳联合黏膜下注射切除结直肠微小息肉临床效果观察[J]. 山东大学学报 (医学版), 2018, 56(6): 47-50.

WEI Mingyong, REN Huiling, WU Jun, PENG Xue, XIE Wenfu, ZHANG Min. Clinical efficacy of endoscopic resection of small colorectal polyps with thermal biopsy forceps[J]. Journal of Shandong University (Health Sciences), 2018, 56(6): 47-50.

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