内镜下高频电切治疗消化道巨大息肉  

Giant polypus in gastrointestinal tract treated by high-frequency electrocogulation under endoscope

作　　者：王一鸣[1] 熊毅敏[1] 许桦林[1] 郑国荣[1] 徐维田[1] 陈建利[1] 

机构地区：[1]广州军区武汉总医院消化内科,湖北武汉430070

出　　处：《局解手术学杂志》2010年第3期210-212,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的评价内镜下高频电切除术联合钛夹、尼龙圈套及氩离子凝固治疗消化道巨大息肉的效果及安全性。方法对我院2005年6月至2009年6月收治的69例患者共112处消化道巨大息肉分别采用钛夹、尼龙圈套及氩离子凝固联合高频电凝切除术的治疗方法进行回顾性分析。结果112枚巨大息肉中,上消化道17枚,结肠86枚,直肠9枚。其中62枚息肉采用尼龙圈套加高频电凝切除术治疗,23枚息肉采用高频电凝切除术加钛夹钳夹术治疗,27枚采用高频电凝切除术加氩离子凝固治疗。术中出血4例(3.5%),内镜下即行氩离子凝固及钛夹止血成功;术后迟发性出血2例(1.8%),急诊内镜下钛夹止血成功。无其他并发症发生。结论高频电切术联合尼龙圈套、金属钛夹及氩离子凝固术是内镜下消化道巨大息肉安全有效的治疗技术。Objective To evaluate the effect and reliability of high-frequency electrocogulation combined with titanium clench,nylon ring or argon plasma coagulation under endoscopy in treatment of giant polyps in digestive tract.Methods Totally 112 giant polypi digestive tract of 69 patients in our hospital from June 2005 to June 2009 were treated by high-frequency electrocogulation combined with titanium clench,nylon ring or argon plasma coagulation.These cases were retrospectively analyzed.Results In 112 giant polypi,17 polypi were located in upper digestive tract,86 in colon,and 9 in rectum.Totally 62 polyps were cured by high-frequency electrocogulation combined with nylon ring,23 were treated with high-frequency electrocogulation allied with titanium clench,and 27 by high-frequency electrocogulation associated with argon plasma coagulation.In all the treatment,intraprocedural bleeding occurred in 4 cases（3.5%）,which were controlled by hemostatic treatment with argon plasma coagulation or titanium clench,2 cases came up with delayed bleeding（1.8%）,and were also cured by titanium clench under emergency therapeutic endoscopy.No other complications occurred.Conclusions High-frequency electrocogulation combined with titanium clench,nylon ring or argon plasma coagulation can effectively prevent bleeding during or after the resection of giant polypoid lesions,which is a safe and effective allied treatment technique for giant polyps in digestive tract.

关 键 词：消化道息肉 高频电切术 钛夹 尼龙圈套器 氩离子凝固术 

分 类 号：R730.49[医药卫生—肿瘤] R730.56[医药卫生—临床医学]