摘要
目的 比较冷圈套治疗(CSP)与热活检钳治疗(HFP)在结肠小息肉切除中的有效性及安全性.方法 2014年1月至2016年12月肠镜检查发现具有3~5mm息肉的患者,随机分配至CSP组及HSP组.比较两组之间的整块切除率(内镜评估)及完全切除率(病理评估),并比较两组术中出血及术中穿孔、迟发出血及穿孔率及息肉回收率.结果 两组患者共有516枚息肉,CSP组265枚,HFP组251枚.HFP组息肉整块切除率为78.1%,完全切除率为HFP 41.7%;CSP组息肉整块切除率为99.2%,完整切除率82.4%,均明显高于HFP组(P<0.001).HFP组术中出血率为7.6%,CSP组术中出血率7.5%,两组之间无显著性差异(P=1.000).所用的病例均成功内镜下止血.CSP组中无迟发性出血及穿孔发生,而HFP组中分别有6例迟发性出血,其中2例行内镜下止血,4例保守治疗后大便自行转黄.HFP组有2例迟发性穿孔发生,均予以外科修补治疗.HFP组标本严重组织损伤率为52.6%,CSP组标本严重组织损伤率为1.2%,显著低于HFP组(P<0.001).HFP组息肉回收失败率为1.6%,CSP组息肉回收失败率为3.8%,两组之间无显著差异(P=0.176).结论 在切除小息肉CSP比HFP有效、安全,CSP是切除小息肉比较理想的一种方法.
Objective To compare cold(CSP)with hot snare polypectomy(HSP)in the safety and efficacy in small colonic polyps 3~5 mm in size.Methods The patient with small colorectal polyps 3〜5mm in size from December 2014 to October 2016 were randomized into CSP group and HFP group.To compare the en-bloc resection rates,complete resection rates,immediate bleeding rate or immediate perforation rate after polypectomy,delayed bleeding or delayed perforation rate,polyp retrieval rate after polypectomy between two groups.Results 516 polyps were evaluated,265 in the CSP group and 251 in the HFP group.In the HFP group,the en-bloc resection rate was 78.1%,and the complete resection rate was 41.7%.The en-bloc resection rate in CSP group was 99.2%,and the complete resection rate was 82.4%.which was significantly higher than that in HFP group(P<0.001).The immediate bleeding rate was 7.6% in the HFP group and 7.5%in the CSP group,with no significant difference between the two groups(P=1.000).Endoscopic hemostasis was successful in all cases.No cases of perforation or delayed bleeding occurred in the CSP group.The delayed bleeding occurred in 6 cases of the HFP group.Two of them stopped bleeding through endoscopic hemostasis.The other stopped bleeding through conservative medical management,2 cases delayed perforation occurred in the CSP group.All of them were treated through surgical repair treatment.The rate of severe tissue damage was 52.6%in the HFP group,and 1.2% in the CSP group,which was significantly lower than that in the HFP group(P<0.001).The rate of Polyp retrieval failure in the HFP group was 1.6% and 3.8% in the CSP group,with no significant difference between the two groups(P=0.176).Conclusion The CSP technique is safe,effective than HSP for patients and it can be considered the ideal procedure for small polyp removal.
出处
《浙江临床医学》
2020年第8期1090-1092,共3页
Zhejiang Clinical Medical Journal