内镜下黏膜剥切术治疗小儿息肉59例临床疗效分析  

Clinical efficacy of endoscopic mucosal resection for the treatment of 59 patients with children's polyps

作　　者：郑晓玲[1] 林海宁[1] 黄正凌 钟世顺[1] 梁玮[1] ZHENG Xiaoging;LIN Haining;HUANG Zhengging;ZHONG Shishun;LIANG Wei(Department of Gastrointestinal Endoscopy Center, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院消化内镜中心,福州350001

出　　处：《福建医药杂志》2018年第2期11-14,共4页Fujian Medical Journal

摘　　要：目的探讨小儿息肉的临床内镜表现和内镜下黏剥切术(EMR)治疗小儿息肉的疗效。方法分析2014—2017年接受EMR治疗的小儿息肉的临床表现、内镜特征、内镜治疗过程、并发症和随访情况。结果共59例患儿纳入研究,男24例,女35例,年龄1~14(4.2±2.7)岁。主要临床表现为大便带血,共57例。56例患儿完成全结肠检查,其中升结肠2例,横结肠2例,降结肠8例,乙状结肠30例,直肠17例。患儿息肉直径1.0~4.0cm,平均(2.04±0.96)cm。所有患儿均接受EMR,1例术后3天并发出血,予内镜下电凝止血成功。无一例出现穿孔、大出血等严重并发症。术后随访至今无一例复发。术后病理结果:幼年性息肉54例,管状腺瘤2例伴低级别上皮内瘤变,炎性息肉3例。结论幼年性息肉是患儿血便的主要原因。对便血患儿麻醉下全结肠镜检查是必要的,以免漏诊。EMR技术切除小儿广基息肉是安全有效的。Objective To evaluate the clinical features and endoscopic manifestations of polyps in children and the therapeutic effect of endoscopic mucosal resection（EMR）in children.Methods The clinical features,endoscopic features of children with polyps from 2014 to 2017 were observed.And the therapeutic effect of EMR,the complications and follow-up results were analyzed.Results There were 59 patients with polyps in the study,including 24 males,35 females.The children were 1-14 years old,with an average age of（4.2±2.7）years old.More children（96.7%,57/59）was hemotohezia.Colonosopy on the entire colon was preformed in the most children（94.9%,56/59）.The locations of polyps were ascending colon（n=2）,transverse colon（n=2）,descending colon（n=8）,sigmoid colon（n=30）,rectum（n=17）.The size of polyps was1.0-4.0 cm,with an average of（2.04±0.96）cm.All the children were treated with EMR,one patient had bleeding at three days after operation,and electrocoagulation was performed successfully under endoscopy.No cases had severe complications such as perforation and massive hemorrhage.No recurrence was found in follow-up.Postoperative pathological findings：the most polyp was juvenile polyp（n=54）,Others were tubular adenoma with low-grade intraepithelial neoplasia（n=2）and inflammatory polyp（n=3）.Conclusion Juvenile polyp is the main cause of children with hemotohezia.The colonoscopy of entire colon for the children with hematochezia is necessary to avoid misdiagnosis.EMR technique is safe and effective for the resection of children＇s polyps.

关 键 词：结肠息肉 内镜下黏膜剥切术 小儿 

分 类 号：R726.5[医药卫生—儿科]