冷圈套与热圈套器切除结直肠4~9 mm息肉的随机对照研究  

A randomized controlled trial of cold snare polyppectomy and hot snare polypectomy for colorectal 4-9 mm polyps

作　　者：吴利娟[1] 田笑笑[1] 金建军[1] 白艳丽[1] 李慧[1] Wu Lijuan;Tian Xiaoxiao;Jin Jianjun;Bai Yanli;Li Hui(Department of Endoscopic Center,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院内镜中心,洛阳471003

出　　处：《中国实用医刊》2019年第23期44-48,共5页Chinese Journal of Practical Medicine

基　　金：河南科技大学校级项目(2015YB-060)。

摘　　要：目的比较分析不通电冷圈套器切除(CPS)与传统热圈套器切除(HSP)治疗结直肠4~9 mm息肉的效果和安全性。方法选取2017年6月至2018年6月于河南科技大学第一附属医院接受结肠镜检查发现直径4~9 mm息肉的365例患者为研究对象,按照随机数字表法将其分为CSP组192例(267枚)与HSP组173例(225枚),分别采用CSP与HSP切除息肉。比较两组患者结肠息肉的组织学完整切除率、标本回收率、出血穿孔并发症、钛夹使用率、单个息肉切除时间、术后腹部不适发生率、病理学检查结果。结果CSP组单个息肉切除时间低于HSP组(P<0.05),CSP组术后腹部不适发生率(13.1%,35/267)、钛夹使用率(15.3%,250/267)低于HSP组(22.6%,51/225;23.1%,52/225),P<0.05。CSP组术中出血率(7.1%,19/267)高于HSP组(3.1%,7/225),而CSP组迟发出血率(0.3%,1/267)低于HSP组(0.9%,2/225),P<0.05。两组其余指标比较差异未见统计学意义(P>0.05)。结论与HSP相比,CSP是一种简单有效且安全的方法,可缩短结直肠直径4~9 mm息肉的切除时间。Objective To compare the efficacy and safety of cold snare polyppectomy(CPS)and hot snare polypectomy(HSP)on 4 to 9 mm colorectal polyps.Methods A total of 365 patients,with 4 to 9 mm polyps,detected in the First Affiliated Hospital of Henan University of Science and Technology from June 2017 to June 2018 were selected and divided into CSP group(192 patients,267 polyps)and HSP group(173 patients,225 polyps)by random number table method.And the two groups were treated by CSP and HSP correspondingly.The complete resection rate,specimen retrieval rate,complications,hemoclip applications rate,abdominal discomfort rate,the time cost of average polyppectomy,pathological examination results were compared between the two groups.Results The resection time for one polyp in CSP group was less than that of HSP group(P<0.05).The incidence of post-polypectomy abdominal symptoms and rate of hemoclip applications in CSP were 13.1%(35/267)and 15.3%(250/267)respectively,which were lower than those of HSP group(22.6%,51/225;23.1%,52/225),P<0.05.Intraoperative bleeding rate in CSP group(7.1%,19/267)was significant higher than in HSP group(3.1%,7/225),but delayed bleeding rate after HSP(0.9%,2/225)was higher than after CSP(0.3%,1/267),P<0.05.However,there was no significant difference in other clinical indexes between the two groups(P>0.05).Conclusions CSP,in the comparison to HSP,is an effective and safe method that shortens the polypectomy duration in 4 to 9 mm polyps.

关 键 词：结肠息肉 息肉切除术 冷圈套 热圈套 

分 类 号：R656[医药卫生—外科学]