胃息肉的病理分型及内镜治疗效果  

Analysis of curative effect and clinical pathology of gastric polyps treated by endoscopic therapy

作　　者：陈立敏[1] 杨国常 李颖欣[1] 孙燕[1] 袁王喜 张玉波[1] 

机构地区：[1]河北省涿州市医院消化内科,072750

出　　处：《现代消化及介入诊疗》2015年第3期199-201,205,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的分析胃息肉的临床病理特征并探讨内镜治疗效果。方法对我院收治的162例胃息肉患者的临床病理特征及内镜治疗效果进行回顾性分析。结果 162例胃息肉患者共计检出198枚息肉,其中增生性息肉68例（41.98%）、炎性息肉60例（37.04%）、胃底腺息肉16例（9.88%）、化生息肉4例（2.47%）、腺瘤性息肉8例（4.94%）、胃癌6例（3.70%）。根据不同年龄分组：≤40岁、41~60岁、〉60岁三组患者的胃息肉病理分布组间差异有统计学意义（P〈0.05）。息肉最大径≤0.5 cm、0.5~2.0 cm、〉2.0cm三组患者的胃息肉病理类型分布组间差异有统计学意义（P〈0.05）。胃息肉病理类型在不同部位分布组间差异有统计学意义（P〈0.05）。胃息肉患者幽门螺杆菌感染阳性率组间差异无统计学意义（P〉0.05）。胃息肉的治疗主要采用高频电凝电切（38.89%）、氩离子凝固术（28.79%）、内镜下黏膜切除术（18.69%）。198枚胃息肉均一次性切除,有5枚较大息肉切除后出血,采用去甲肾上腺素和APC止血后未见活动性出血,1例患者出现术后迟发型出血,对症保守治疗后出血停止,术后随访未见穿孔、感染等并发症。术后3个月和1年随访有9例患者出现复发,复发率5.56%。结论胃息肉好发于老年患者,多为单发,直径较小,常见于胃体。采用内镜下切除治疗能够取得较为理想的疗效。Objective To investigate the clinical pathological characteristics of gastric polyps and ex- plore the endoscopic treatment effect. Methods A retrospective analysis was conducted for 162 patients with gastric polyps who were admitted to Zhuzhou Hospital of Hebei province from May, 2011 to May, 2013, so as to evaluate the effect of endoscopic treatment and clinical pathological characteristics. Results One hundred and ninety eight gastric polyps were detected in 162 cases, including 68 cases of hyperplastic polyps （41.98%）, 60 cases of inflammatory polyps （37.04,%）, 16 cases of fundic gland polyps （9.88%）, 4 cases of metaplastic polyps （2.47%）, 8 cases of adenomatous polyps （4.94%）, and 6 cases of gastric cancer （3.70%）. The patients were divided into three groups according to the different ages： ~〈40 year-old, 41 ~ 60 year-old, and 〉 60 year-old. There was a statistically significance among different groups in the distribution of gastric polys, and pathological type（P 〈 0.05）. The pathological types of gastric polyps in different position had statistically sig- nificant among 3 groups （P 〈 0.05） depending on the diameter of polyps. Similarly, the statistically significance was found in different groups based on polyps location, but there was no relation between gastric polyps and H. pylori infection （P 〉 0.05）. The treatment of gastric polyps included high frequency electrocoagulation （38.89%）, argon plasma coagulation （28.79%）, and endoscopic mucosal resection （18.69%）. 198 gastric polyps were resected in one time, bleeding occurred after resection in 5 large polyps which followed by nore- pinephrine and APC treatment to stop bleeding. Late postoperative bleeding occurred in one patient, the bleed- ing was stopped after conservative treatment. There was no perforation, infection, and other complications. Nine patients had recurrence during 3-month to 1-year follow-up （5.56%）. Conclusion Gastric polyps in el- derly patients were mostly single with sm

关 键 词：胃息肉 胃镜 治疗效果 安全性 病理特征 

分 类 号：R735.34[医药卫生—肿瘤]