内镜下冷圈套切除大肠小息肉在服用抗栓药物患者中的应用  

Application of endoscopic cold snare resection of small colorectal polyps in patients taking antithrombotic drugs

作　　者：孙超[1] 朱滢[1] 柴海娜[1] 徐晓玲[1] 王璐[1] 陈超伍[1] 刘军[1] Sun Chao;Zhu Ying;Chai Haina;Xu Xiaoling;Wang Lu;Chen Chaowu;Liu Jun(Endoscopy Center,Northern Jiangsu People′s Hospital of Jiangsu Province,Yangzhou 225001,China)

机构地区：[1]江苏省苏北人民医院内镜中心,江苏扬州225001

出　　处：《中华消化病与影像杂志（电子版）》2021年第5期200-203,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的探讨内镜下圈套器冷切除治疗服用抗栓药物患者结直肠小息肉的临床可行性及其安全性。方法回顾分析2019年1月至2020年12月在江苏省苏北人民医院行内镜下冷圈套切除术治疗的42例不停用抗栓药物患者的结直肠小息肉(3~9 mm)临床资料,对息肉切除的术中活动性出血、穿孔、术后迟发性出血、切除的完整性、标本完整回收情况以及术后感染等情况进行分析。结果42名服用抗栓药物的患者共发现65枚结直肠扁平小息肉,在内镜下行圈套冷切除术。所有息肉平均直径5.9 mm(3~9 mm),标本全部完整回收,完整回收率100%。62枚小息肉冷切除术中即有少量的渗血,等待观察出血均可自行停止。3枚小息肉术中出现活动性渗血,术中出血率4.62%,给予金属钛夹夹闭创面后出血停止。所有患者冷切除术后未出现术中术后穿孔、术后迟发性出血及感染并发症。所有患者术后病理提示切缘阴性,完整切除率100%。结论内镜下冷圈套切除术是治疗服用抗栓药物患者结直肠小息肉安全有效的一种手术方式。Objective To investigate the clinical feasibility and safety of endoscopic snare cold resection in the treatment of small colorectal polyps in patients taking antithrombotic drugs.Methods The clinical data of 42 patients with small colorectal polyps(3-9 mm)who underwent endoscopic cold snare resection in Northern Jiangsu People′s Hospital of Jiangsu Province from January 2019 to December 2020 were retrospectively analyzed.The active bleeding,perforation,delayed postoperative bleeding,integrity of resection,complete recovery of specimens and postoperative infection were analyzed.Results A total of 65 small flat colorectal polyps were found in 42 patients who took antithrombotic drugs,and were treated with cold snare resection under endoscopy.The average diameter of all polyps was 5.9 mm(3-9 mm).All specimens were recovered completely,and the complete recovery rate was 100%.A small amount of bleeding occurred in the cold resection of 62 small polyps,which stopped after observation.Active oozing occurred in 3 small polyps during the operation,and the intraoperative bleeding rate was 4.62%.The bleeding stopped after the wound was clamped by a metal titanium clip.No intraoperative and postoperative perforation,delayed postoperative bleeding and infection complications occurred in all patients after cold resection.Postoperative pathology showed negative surgical margin in all patients,and the complete resection rate was 100%.Conclusion Endoscopic cold snare resection is a safe and effective surgical method for the treatment of small colorectal polyps in patients taking antithrombotic drugs.

关 键 词：冷圈套切除术 大肠息肉 抗栓治疗 

分 类 号：R574.6[医药卫生—消化系统]