内镜下氩离子凝固术治疗胃肠道息肉446例临床分析  

Endoscopic argon plasma coagulation for gastrointestinal polyps in 446 cases

作　　者：杨琦[1] 王景杰[1] 杨晔[2] 闻勤生[1] 秦明[1] 赵宝民[1] 王旭霞[1] 赵曙光[1] 刘震雄[1] 张少玲[1] 黄裕新[1] 

机构地区：[1]第四军医大学唐都医院消化科,陕西西安710038 [2]第四军医大学唐都医院胸外科,陕西西安710038

出　　处：《第四军医大学学报》2009年第3期268-270,共3页Journal of the Fourth Military Medical University

摘　　要：目的:探讨内镜下氩离子凝固术,介入治疗胃肠道息肉的应用价值及疗效.方法:采用德国ERBE公司生产的APC300型内镜专用氩气刀,对经病理学证实为胃肠道息肉进行氩离子凝固术,氩离子凝固治疗以内镜下整个病灶凝固为止,每枚息肉根据其部位、大小决定氩离子凝固次数.结果:采集446例患者共659枚息肉,其中508枚为直径小于5 mm的扁平、广基息肉.经内镜氩离子凝固术治疗,3 mo内复查内镜病变全部消除,治愈率为100%;直径大于5 mm广基或亚蒂、细蒂息肉136例,118例经1次氩离子凝固术治疗,3 mo后复查内镜病变全部消除.18例经第2次氩离子凝固术治疗,3 mo后再次复查内镜病变消除;另有15枚有蒂息肉,在内镜圈套高频电刀治疗同时,采用内镜下氩离子凝固术配合治疗,3 mo后再次复查内镜病变全部治愈.结论:内镜下氩离子凝固术对胃肠道广基、扁平息肉或息肉样隆起治愈率高、疗效显著,且简便易行、并发症少,有较高的临床应用价值.AIM： To evaluate the values and therapeutic effects of endoscopic argon plasma coagulation （APC） in the treatment of gastrointestinal （GI） polyps. METHODS： GI polyps confirmed pathologically were coagulated by argon plasma generated by German-made ERBE APC 300 EA. The number of times of coagulation for each polyp was determined by its size and location. RESULTS： A total of 659 polyps in 446 cases were investigated. Five hundred and eight flat and thin （ diameter 〈 5 mm） sessile polyps were totally removed by APC （ 100% ）. Among the 136 sessile polyps with diameter 〉 5 mm, 118 cases were removed by one-time APC and 18 flat polyps were removed by two-time APC. Fifteen pedunculated polyps were removed by combination of APC and high frequency electron surgical unit. CONCLUSION： APC is safe and effective in the treatment of GI polyps, especially in the treatment of flat and thin sessile gastrointestinal polyps.

关 键 词：内镜 氩离子凝固术 息肉 介入治疗 

分 类 号：R573.2[医药卫生—消化系统]