应用尼龙圈联合钛夹预防结肠息肉切除后出血  

Combined endoloop and endoclip application for prevention of postpolypectomy bleeding

作　　者：李连勇[1] 屈昌民[1] 曾柏伦[1] 王晓英[1] 梁淑文[1] 

机构地区：[1]中国人民解放军第306医院消化内科,北京市100101

出　　处：《世界华人消化杂志》2015年第25期4119-4124,共6页World Chinese Journal of Digestology

摘　　要：目的:评价尼龙圈联合钛夹方法在预防结肠大息肉切除后出血的价值.方法:回顾性研究经肠镜下切除直径≥2 cm有蒂息肉患者的临床资料.对照组采用混合电流切除并采用钛夹预防出血,实验组采用尼龙圈套扎后混合电流切除,然后再行钛夹预防出血.对早期出血率、迟发性出血率、严重出血发生率及住院天数进行比较.结果:本研究共有66例患者72枚息肉进行肠镜下混合电流切除.其中对照组42枚息肉,实验组30枚息肉.总出血发生率为6.94%(5/72),对照组有4例出现出血,出血发生率为9.52%,3例早期出血,1例迟发性出血.实验组1例发生迟发性出血,发生率为3.13%,无早期出血发生.两组出血发生率比较差异无统计学意义.对照组中出现1例大量出血并需输血治疗.实验组肠镜操作过程较对照组时间延长(P=0.027),但住院天数明显下降(P=0.047).结论:尼龙圈联合钛夹是预防结肠息肉切除术后出血发生的一种有效措施.AIM： To evaluate the value of combined endoloop and hemoclip application as a prophylactic method for postpolypectomy bleeding in patients with large （≥2 cm） pedunculated colonic polyps. METHODS： Patients with pedunculated colonic polyps （≥2 cm） were included in this study retrospectively and divided into a control group and an experimental group. In the control group, endoclips were used after conventional polypectomy. In the experimental group, an endoloop was placed at the base of the stalk followed by conventional polypectomy and clip application in the residual stalk above the snare. The efficacy in preventing early and late postpolypectomy bleeding, rate of severe bleeding, and days of hospitalization were evaluated. RESULTS： Overall, bleeding complications occurred in 5/72 polyps （6.94%）. In the control group （endoclips alone）, 4/42 （9.52%） had a bleeding episode： three （7.14%） occurred during the first 24 h and one （2.3%） between days 1 and 30 from the procedure. In the experimental group only 1 of 32 polyps （3.12%） had a late bleeding episode （P = 0.275）. Severity of late bleeding in the experimental group （one case of moderate bleeding） vs the control group （3 cases of moderate and one case of severe bleeding） and need for transfusions （0 vs 2 blood units） were lower. Colonoscopy time was significantly higher in the experimental group vs the control group （P = 0.027）, but hospitalization days were shorter in the experimental group （P = 0.047）. CONCLUSION： Endoloop combined with endoclip technique seems to be more effective than endoclip postpol colonic ypectomy bleeding polyps. alone in preventing in large pedunculated

关 键 词：结肠息肉 尼龙圈 钛夹 预防出血 

分 类 号：R656.9[医药卫生—外科学]