内镜黏膜下剥离术与高频电圈套器套切术应用于2~4 cm巨大息肉的效果比较  

Comparative Analysis of Endoscopic Submucosal Dissection and High-Frequency Electric Resection in the Treatment of 2-4 cm Huge Polyps

作　　者：田丽 吴宗峰 田甜[1] TIAN Li;WU Zongfeng;TIAN Tian(Department of Endoscopy Clinic,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院内镜诊疗部,河南南阳473000

出　　处：《河南医学研究》2021年第32期5998-6001,共4页Henan Medical Research

摘　　要：目的分析内镜黏膜下剥离术(ESD)与高频电圈套器套切术应用于2~4 cm巨大息肉的疗效分析。方法选择南阳市中心医院2019年1月1日至2020年1月1日收治的2~4 cm巨大息肉患者87例。使用随机数字表法将其分成A组(n=43)、B组(n=44)。A组患者接受ESD治疗,B组接受高频电圈套器套切术治疗。疼痛评定采用视觉模拟评分法(VAS),比较两组患者一般指标(切除息肉个数、息肉切除时间和出血量)、疼痛情况、炎症因子[白细胞计数(WBC)和C-反应蛋白(CRP)]水平、疗效、并发症和复发情况。结果 A组和B组患者切除息肉个数差异比较无统计学意义(P>0.05),但B组息肉切除时间[(63.87±0.39)min]短于A组,出血量[(48.98±3.05)mL]少于A组(P<0.05)。术后,两组患者VAS较术前增加(P<0.05);且B组患者术后2、12 h VAS低于A组(P<0.05)。术后,两组患者WBC和CRP水平较术前下降。B组患者术后WBC[(3.04±0.14)×10^(9) L^(-1)]和CRP[(1.01±0.33)mg·L^(-1)]水平低于A组(P<0.05)。B组患者临床总有效率(97.73%)高于A组(P<0.05)。两组患者并发症发生率差异比较无统计学意义(P>0.05),B组复发率(4.55%)低于A组(P<0.05)。结论 ESD与高频电圈套器套切术均能治疗2~4 cm巨大息肉,其中高频电圈套器套切术能提升临床治疗效果,降低复发率和炎症反应,推荐使用。Objective To analyze the efficacy of endoscopic mucosal dissection(ESD) and high-frequency electric resection in the treatment of 2-4 cm huge polyps.Methods Eighty-seven patients with 2-4 cm huge polyps were selected from January 1,2019 to January 1,2020.According to random number table method,they were divided into group A(n=43) and group B(n=44).Group A received ESD treatment,group B received high-frequency electric resection treatment.Pain was assessed using the visual analogue score(VAS).The general indexes(number of polyps removed,time of polyps resection,and bleeding volume),pain,inflammatory factor[white blood cell(WBC) and C-reactive protein(CRP)] level,curative effect,complications and recurrence of the two groups were compared.Results There was no significant difference in the number of polyps removed between group A and group B(P>0.05),but the time of polyps resection in group B [(63.87±0.39)min] was shorter than that in group A,and bleeding volume [(48.98±3.05)mL] was less than that in group A(P<0.05).After operation,VAS of the two groups increased compared with that before operation(P<0.05),and VAS of group B was lower than that of group A after operation 2,12 h(P<0.05).After operation,the levels of WBC and CRP in the two groups were lower than those before operation.WBC of group B was [(3.04±0.14)×10^(9) L^(-1)] and CRP was [(1.01±0.33)mg·L^(-1)],which were lower than that in group A(P<0.05).The total effective rate of group B was 97.73%,which was higher than that of group A(P<0.05).There was no significant difference in the complication rate between the two groups(P>0.05).The recurrence rate of group B was 4.55%,which was lower than that of group A(P<0.05).Conclusion Both ESD and high-frequency electric resection can treat 2-4 cm huge polyps,and high-frequency electric resection can improve the clinical treatment effect,reduce the recurrence rate and inflammatory activity,which is recommended.

关 键 词：内镜黏膜下剥离术 高频电圈套器套切术 巨大息肉 

分 类 号：R57[医药卫生—消化系统]