不同内镜方式治疗对结肠息肉患者的效果及术后迟发性出血的原因分析  

Analysis on the Effects of Different Endoscopic Treatments on Patients with Colon Polyps and the Causes of Delayed Postoperative Bleeding

作　　者：植中敬[1] ZHI Zhongjing(Department of Gastroenterology,Zhaoqing Second People's Hospital,Zhaoqing,Guangdong Province,526020 China)

机构地区：[1]肇庆市第二人民医院消化内科,广东肇庆526020

出　　处：《中外医疗》2021年第30期13-16,共4页China & Foreign Medical Treatment

基　　金：肇庆市科技创新指导类项目(201804030729)。

摘　　要：目的不同内镜方式治疗对结肠息肉患者的效果及术后迟发性出血的原因分析。方法随机选取该院2017年1月—2020年10月收治的结肠息肉患者200例,以随机数表法分为两组,每组100例。参照组以结肠镜下息肉切除术治疗,观察组以无痛结肠镜下息肉切除术治疗,比较两组手术时间、术中出血量、胃肠功能恢复时间和病灶遗留、肠壁穿孔、做完手术迟发性出血、感染发生率,根据患者术后息肉改变情况和患者症状改善情况进行疗效评价。结果观察组手术时间(67.45±10.28)min、术后胃肠功能恢复时间(22.32±6.23)h短于参照组(75.30±10.32)min、(28.05±6.20)h,术中出血量(30.23±8.20)mL低于参照组(36.50±8.75)mL,差异有统计学意义(t=5.389、6.519、5.229,P<0.05);观察组病灶残留2.00%、肠壁穿孔3.00%、迟发性出血4.00%、感染5.00%发生率低于参照组9.00%、10.00%、12.00%、13.00%,差异有统计学意义(χ^(2)=4.714、4.031、4.348、3.907,P<0.05)。观察组患者的总有效率93.0%高于参照组患者的总有效率83.0%,差异有统计学意义(P<0.05)。结论不同内镜方式治疗结肠息肉,在临床疗效上有显著差异,无痛结肠镜下息肉切除术能够提高手术效率,减轻手术创伤,充分切除结肠息肉,减少术后迟发性出血等多种并发症发生。Objective To analyze the effects of different endoscopic methods on patients with colon polyps and the causes of delayed postoperative bleeding.Methods A total of 200 colon polyps patients admitted to the hospital from January 2017 to October 2020 were conveniently selected and divided into two groups by random number table,100 cases per group.The reference group was treated with colonoscopy poly pectomy,and the observation group was treated with painless colonoscopic polypectomy.Comparison of operation time,intraoperative blood loss,gastrointestinal function recovery time,residual lesions,intestinal perforation,delayed bleeding after surgery,and incidence of infection between the two groups.The curative effect was evaluated according to the postoperative polyp change and the improvement of the patient's symptoms.Results The operation time of the observation group was(67.45±10.28)min and the postoperative gastrointestinal function recovery time(22.32±6.23)h was shorter than the reference group(75.30±10.32)min and(28.05±6.20)h.The intraoperative blood loss(30.23±8.20)mL was lower than the reference group(36.50±8.75)mL,the difference was statistically significant(t=5.389,6.519,5.229,P<0.05).The incidence of residual lesions in the observation group 2.00%,intestinal wall perforation 3.00%,delayed bleeding 4.00%,and infection 5.00%were lower than the reference group 9.00%,10.00%,12.00%,and 13.00%.The difference was statistically significant(χ^(2)=4.714,4.031,4.348,3.907,P<0.05).The total effective rate of patients in the observation group was 93.0%higher than the total effective rate of patients in the reference group of 83.0%,the difference was statistically significant(P<0.05).Conclusion Different endoscopic methods for the treatment of colon polyps have significant differences in clinical efficacy.Painless colonoscopic polypectomy can improve the efficiency of surgery,reduce surgical trauma,fully remove colon polyps,and reduce the occurrence of various complications such as delayed postoperative bleeding.

关 键 词：结肠息肉 结肠镜 腹腔镜 内镜诊疗 迟发性出血 息肉残留 

分 类 号：R47[医药卫生—护理学]