肠镜下结肠巨大息肉切除124例临床分析  

Clinical Analysis of 124 Cases of Giant Colon Polypectomy Under Enteroscope

作　　者：彭魏[1] 陈仕武[1] 李鑫[1] PENG Wei;CHEN Shiwu;LI Xin(Department of Gastroenterology,The 921^(st)Hospital of The Joint Logistics Support Forces of The Chinese People’s Liberation Army,Changsha Hu'nan 410003,China)

机构地区：[1]中国人民解放军联勤保障部队第921医院消化内科,湖南长沙410003

出　　处：《中国卫生标准管理》2021年第3期71-74,共4页China Health Standard Management

摘　　要：目的探讨肠镜下结肠巨大息肉切除的临床可行性、有效性和安全性。方法回顾性分析2016年1月-2020年2月我院电子内窥肠镜发现直径>2 cm的巨大结肠息肉患者124例,对于蒂粗>1.0 cm的48例巨大息肉分为A组,行钛夹后圈套器电切,对于蒂粗≤1.0 cm的76例巨大息肉分为B组,行钛夹后氩气刀切,观察两组的病理类型、有效切除率、术后并发症发生率、手术时间。结果结肠巨大息肉主要分布在直肠和乙状结肠,分别为43.48%、35.51%;肿瘤性息肉和非肿瘤性息肉分别为77.54%和22.46%;A组的有效切除率、手术平均时间和术后出血并发症分别为96.43%、(25.68±6.12)min、6.25%。B组的有效切除率、手术平均时间和术后出血并发症分别为97.56%、(23.12±3.24)min、6.58%。结论巨大结肠息肉主要分布在直肠和乙状结肠,主要以肿瘤性息肉为主,对于蒂粗≤1.0 cm的巨大息肉者采用钛夹后氩气刀切除,蒂粗>1.0 cm的巨大息肉采用钛夹后圈套器电切较为有效。Objective To explore the clinical feasibility,effectiveness and safety of colonoscopic large polypectomy.Methods 124 patients with giant colonic polyps with a diameter>2 cm found in our hospital by electronic endoscopy from January 2016 to February 2020 were retrospectively analyzed.Snare polypectomy after installing the titanium clip were used to remove among 48 cases with a pedicle thickness>1.0 cm(group A),and 76 cases of giant polyps with pedicle thickness≤1.0 cm underwent cutting off with an argon gas knife after installing the titanium clip(group B).The pathological type,effective resection rate,postoperative complication rate and operation time of the two groups were observed.Results Large colonic polyps were mainly distributed in the rectum and sigmoid colon,with 43.48%and 35.51%,respectively;tumor polyps and non-tumor polyps were 77.54%and 22.46%,respectively;the effective resection rate,average operation time,and postoperative bleeding complications in the group A were 96.43%,(25.68±6.12)min,and 6.25%,respectively.The effective resection rate,average operation time,and postoperative bleeding complications in the group B were 97.56%,(23.12±3.24)min,and 6.58%,respectively.Conclusion Giant colonic polyps are mainly distributed in the rectum and sigmoid colon,mainly neoplastic polyps.It is more effective to cut off with an argon gas knife after installing the titanium clip for giant polyps with a pedicle thickness≤1.0 cm,and snare polypectomy after installing the titanium clip for giant polyp with a pedicle thickness greater than 1.0 cm.

关 键 词：肠镜 结肠巨大息肉 钛夹 氩气刀 圈套电切 疗效 

分 类 号：R656[医药卫生—外科学]