内镜下高频电凝刀电切除术治疗结肠息肉240例的临床体会  

Clinical experience of endoscopic high-frequency electric coagulation knife in 240 cases of resection of colon polyps

作　　者：刘鹏军[1] 葛亚强[1] 王晓燕 张利霞[1] 许丽娟[1] 徐敏 

机构地区：[1]江苏大学附属武进医院消化内科,江苏常州213002 [2]江苏省宿迁市第一人民医院消化科,江苏宿迁223800

出　　处：《中国现代医生》2015年第33期87-89,93,共4页China Modern Doctor

基　　金：江苏省常州市武进区科技计划(WS201421)

摘　　要：目的分析内镜下高频电凝刀电切除术治疗结肠息肉的临床疗效与安全性,为结肠息肉外科治疗提供参考。方法选择我院2013年1月-2015年6月收治的240例结肠息肉患者为研究对象,对其临床诊治情况进行回顾性分析。结果 240例患者中235例顺利完成内镜下治疗,4例患者因术中出血量大转外科治疗,1例因息肉偏大转外科手术。平均手术时间（30.46±5.27）min,术中平均出血量（14.97±2.31）m L,平均卧床时间（2.36±0.54）d,平均住院时间（3.85±1.26）d。患者治疗后1周[（12.74±2.23）vs（9.28±1.59）]、2周[（20.06±3.72）vs（9.28±1.59）]的ADL评分均明显高于治疗前,差异具有统计学意义（P〈0.05）。治疗后1周[（19.47±2.91）vs（43.68±5.26）]、2周[（19.47±2.91）vs（43.68±5.26）]的HAMD评分均低于治疗前,差异具有统计学意义（P〈0.05）。在并发症方面,接受内镜治疗的患者中发生3例肠穿孔、5例腹胀、6例术后综合征,无腹腔感染、大出血等。结论内镜下高频电凝刀切除术治疗结肠息肉疗效确切、安全性高,值得临床广泛推广。但对于息肉直径大、术中出血量大及有恶性肿瘤的患者并不适用,实际应用时应充分考虑患者的具体情况。Objective To analyze the clinical efficacy and safety of endoscopic high-frequency electric coagulation knife in resection of colon polyps, and to provide a reference for the surgical treatment of colon polyps. Methods 240 cases of colon polyp patients in our hospital from January 2013 to June 2015, were chosen as study objectives, and retrospective analysis was conducted on the clinical diagnosis and treatment. Results Among 240 cases of patients, 235 cases successfully completed endoscopic therapy, 4 cases transferred to receive surgical treatment because of great blood loss, and 1 case turned to surgical operation due to too large polyps. The mean operative time was（30.46 ±5.27）minutes, and the mean intraoperative blood loss was（14.97±2.31） ml. The average bed time was（2.36±0.54） days, and the average length of hospitalization was（3.85±1.26） days. The ADL scores of patients in the two groups one week and two weeks after operation were（12.74 ±2.23 vs 9.28 ±1.59） and（20.06 ±3.72 vs 9.28 ±1.59） respectively, significantly higher than those before operation, and the differences were statistically significant（P〈0.05）. HAMD scores of patients in the two groups one week and two weeks after operation were（19.47±2.91 vs 43.68±5.26） and（19.47±2.91 vs 43.68±5.26）,lower than those before operation, and the differences were statistically significant（P〈0.05）. In terms of complications, among patients receiving endoscopic treatment, there were three cases of intestinal perforation, 5 cases of abdominal distension and 6 cases of postoperative syndrome, without abdominal infection, bleeding and other adverse reactions. Conclusion Endoscopic high-frequency electric coagulation knife in resection of colon polyps is curative, safe,and worthy of wider promotion. But it does not apply to patients with large diameter polyps, large blood loss and therioma, and full consideration of the specific situation of patients should be taken in practical application.

关 键 词：内镜 高频电凝刀 结肠息肉 安全性 

分 类 号：R574.62[医药卫生—消化系统]