经结肠镜高频电圈套器联合尼龙绳套扎和/或钛夹钳夹治疗大肠宽蒂和大息肉156例  

Treatment of large colorectal polyps with wide peduncle by nylon endoloop ligature and/or clamping with titanium clips in combination with colonoscopy-assisted high-frequency electric snare:an analysis of 156 cases

作　　者：王萍[1] 吴杰[1] 黄晓东[1] 孙圣斌[1] 张姮[1] 郑丹[1] 宋敏[1] 刘文敏[1] 

机构地区：[1]武汉市中心医院消化内科,湖北省武汉市430014

出　　处：《世界华人消化杂志》2010年第17期1838-1841,共4页World Chinese Journal of Digestology

摘　　要：目的:评价结肠镜下高频电圈套器联合尼龙绳套扎和/或钛夹钳夹摘除大肠宽蒂、大息肉的疗效及安全性.方法:结肠镜下宽蒂息肉先予尼龙绳套扎其息肉根部,再予高频电圈套器凝切;大息肉(直径大于2.0cm者)先予钛夹2-3枚在息肉根部钳夹,然后再用高频电圈套器分块凝切.结果:结肠镜治疗大肠息肉788例、其中宽蒂、大息肉156例(宽蒂67例、大息肉89例),经予上述方法进行内镜下摘除,一次性切除息肉102枚(65.38%),分次切除54枚(34.62%),均获满意疗效,其中即刻出血2例(1.28%),立即给予内镜下血凝酶喷洒、电凝和/或钛夹,即时止血,无迟发出血.全部病例无1例穿孔.结论:经结肠镜高频电圈套器摘除消化系宽蒂、大息肉前给予尼龙绳套扎和/或钛夹钳夹息肉根部,明显减少了出血、穿孔等并发症,突破了以往内镜治疗息肉关于大小、宽蒂等禁区,避免了手术引起的创伤,安全可靠,值得推荐.AIM：To assess the efficacy and safety of nylon endoloop ligature and/or clamping with titanium clips in combination with colonoscopy-assisted high-frequency electric snare in the treatment of colorectal polyps.METHODS：Patients with colorectal polyps with wide peduncle underwent a nylon endoloop snare first,followed by treatment by colonoscopy-assisted high-frequency electric snare.For patients with polyps larger than 2 cm,clamping with titanium clips in combination with electrocoagulation and electrocision was performed.RESULTS：A total of 788 cases of colorectal polyps,including 67 with wide peduncle and 89 larger than 2 cm,were treated by colonoscopy.Of these cases,102 （65.38%） were resected totally,54 （34.62%） were excised in stages.Two patients （1.28%） suffered from immediate bleeding and underwent hemocoagulase treatment,electric coagulation and （or） clamping with titanium clips.No perforation occurred.CONCLUSION：Nylon endoloop ligature and/or clamping with titanium clips in combination with colonoscopy-assisted high-frequency electric snare is effective and safe in the treatment of large colorectal polyps with wide peduncle

关 键 词：结肠镜 高频电 圈套器 套扎 大肠息肉 

分 类 号：R735.34[医药卫生—肿瘤]