摘要
目的 比较不同圈套器在老年患者结肠小息肉切除的有效性和安全性.方法 选取结肠镜检查并发现结肠息肉的105例老年患者,按随机数字表法分为专用冷圈套器息肉冷切除术组(专用冷圈套器组)、常规圈套器息肉冷切除术组(对照组)和圈套器息肉电切切除术组(HSP组),各35例.比较三组病例的一般情况,通过结肠镜检查观察息肉位置、大小、数量、NICE分型、息肉切除时间、标本回收率、并发症(包括术中及术后2周内的出血、穿孔、腹痛、腹胀)、结肠病变的息肉完全切除率、病理学结果及标本黏膜下层的累及损伤情况.结果 专用冷圈套器组的息肉切除时间明显短于HSP组和对照组(t分别=9.77、2.24,P均<0.05),息肉完全切除率高于HSP组,标本黏膜下层的累及损伤率均低于HSP组(χ2分别=5.15、6.17,P均<0.05),迟发型出血发生率和腹痛等症状发生率少于HSP组,差异均有统计学意义(P均<0.05).三组在息肉大小、切除息肉数量,以及在息肉位置、NICE分型、标本回收率等方面比较,差异均无统计学意义(F分别=0.08、0.11,χ2分别=1.05、0.51、0.38,P均>0.05).三组患者息肉切除术后观察,病理分型、异型性,以及出血、腹胀等并发症发生率比较,差异均无统计学意义(χ2分别=1.34、0.17、1.68、1.50,P均>0.05).结论 对老年患者结肠小息肉,专用冷圈套器比较传统的圈套器在冷切除及高频电凝电切结肠小息肉,在手术时间、迟发型出血发生率、息肉完全切除率、减少标本黏膜下层的累及损伤等方面有优势.
Objective To compare the efficacy and safety of different snares in the treatment of colonic polyp in elderly patients.Methods Totally 105 elderly patients with colonic polyps detected by colonoscopy were randomly divided into three groups:special cold snare device group,control group,and hot snare polypectomy(HSP)group,35 cases in each.The position,size,quantity,NICE classification,time of polypectomy,recovery rate of specimens,complications such as bleeding rate,perforation,abdominal pain,complete resection rate of polyps in colonic lesions,pathological results and submucosal injury were observed.Results The time of polypectomy in the special cold snare device group was significantly shorter than that in the HSP group and the control group(t=9.77,2.24,P<0.05),the rate of complete histologic resection was higher than that in the HSP group,the rate of submucosal injury was lower than that in the HSP group(χ2=5.15,6.17,P<0.05),the incidence of postoperative bleeding and the incidence of abdominal pain were lower than that in the HSP group,the differences were statistically significant(P<0.05).There was no significant difference in the polyps size,the number of polyps removed,the location of polyps,NICE classification,and sample recovery rate among the three groups(F=0.08,0.11,χ2=1.05,0.51,0.38,P>0.05).There was no significant difference in pathological classification,heteromorphism,incidence of bleeding and abdominal distention among the three groups(χ2=1.34,0.17,1.68,1.50,P>0.05).Conclusion As for colonic polyps in elderly patients,the special snare device has advantages in polypectomy time,postoperative bleeding,pathological complete resection rate,and submucosal injury.
作者
李华铭
何亚红
朱伟琴
李珍
郭艳
王宇芳
LI Huaming;HE Yahong;ZHU Weiqin(Department of Digestive Medicine,The Third People’s Hospital of Hangzhou,Hangzhou 310009,China)
出处
《全科医学临床与教育》
2020年第5期423-426,共4页
Clinical Education of General Practice
