内镜下预处理结直肠带蒂息肉预防切除后出血研究  

Pretreating colonic polyps under endoscopy to prevent bleeding after polyp resection

作　　者：穆晨[1] 李贞娟[1] 令狐恩强[1] 张楠[1] 班永玲 

机构地区：[1]解放军总医院消化内科,北京100853

出　　处：《中华胃肠内镜电子杂志》2017年第2期53-55,共3页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

摘　　要：目的探索结直肠带蒂息肉内镜下应用金属夹和尼龙绳预处理预防切除后出血的有效性及应用价值。方法纳入解放军总医院消化内科2015年6月至2016年12月患有结直肠带蒂息肉并行内镜下治疗的99例患者。根据内镜下息肉切除前于息肉蒂部进行阻断血流方式分为:金属夹组71例和尼龙绳组28例,记录相关数据,分析2种治疗方式的有效性及安全性。结果所有病例息肉均成功切除,2组出血率分别为7.14%和5.63%(P=0.002),2组术中出血率分别为7.14%和1.43%(P=0.001),术后出血率分别为0和4.23%(P=0.001),手术时间平均为(26.18±19.7)min和(27.61±16.24)min(P=0.3312),手术费用分别为(4 226.89±1 517.31)元和(4 801.99±2 331.76)元(P=0.76),术后住院天数分别为(5.85±3.29)d和(6.39±2.52)d(P=0.0206)。结论在行结直肠带蒂息肉内镜下切除预处理时,金属夹可有效降低术后出血率、术后住院天数,建议应用金属夹夹闭息肉蒂部。Objective To evaluate the effectiveness and application value of pretreating colonic polyps by clip and endoloop for preventing bleeding after resection. Methods Patients with colorectal polyps that treated by endoscopy from June 2015 to December 2016 in Department of Gastroenterology,Chinese PLA General Hospital were included into the study. Patients were divided into two groups by the application of clip and endoloop group. Data of the patients were recorded and analyzed to compare the safety and effectiveness between the two groups. Results A total of 99 patients were included into this study,among whom 28 cases were divided into group A and 71 cases were divided into group B. Bleeding occurred in 7. 14% of the patients in group A but 5. 63% in group B（ P = 0. 002）. Average operation time were（ 26. 18 ± 19. 7） min and（ 27. 61 ± 16. 24） min（ P = 0. 3312）. Operation costs were（ 4 226. 89 ±1 517. 31） $ and（ 4 801. 99 ± 2 331. 76） $（ Group A vs. Group B,P = 0. 76）. Postoperative hospital stay were（ 5. 85 ± 3. 29） days and（ 6. 39 ± 2. 52） days（ Group A vs. Group B,P = 0. 0206）. Conclusion Using clip to block the colonic polyps can decrease the bleeding rate and hospital stay in post-operation and is a better way to prevent bleeding in endoscopic colonic polyp resection.

关 键 词：息肉 金属夹 尼龙绳 

分 类 号：R574[医药卫生—消化系统]