结肠息肉内镜下治疗的并发症分析  

Analysis of complications after endoscopic therapy of colonic polyps

作　　者：宰德富 张丽丽 ZAI De-fu;ZHANG Li-li(People's Hospital of Qihe County,Dezhou 251100,China)

机构地区：[1]齐河县人民医院,251100

出　　处：《中国实用医药》2022年第15期7-11,共5页China Practical Medicine

摘　　要：目的 分析内镜下治疗结肠息肉的各种并发症发生情况。方法 2156例行无痛电子结肠镜检查并行内镜下治疗的结肠息肉患者,观察患者术后并发症发生情况,对比不同性别、年龄、手术史、息肉数目及操作方式患者术后并发症发生情况。结果 2156例患者中,95例(4.41%)出现并发症,其中出血36例(1.67%),穿孔4例(0.19%),腹痛34例(1.58%),感染21例(0.97%),无一例死亡。不同性别患者术后并发症发生率比较差异无统计学意义(P>0.05);年龄≥60岁患者术后并发症发生率5.62%高于年龄<60岁患者的3.55%,差异具有统计学意义(P<0.05);有手术史患者术后并发症发生率8.53%高于无手术史患者的4.14%,差异具有统计学意义(P<0.05);息肉数目≥2枚患者术后并发症发生率4.86%高于息肉数目1枚患者的1.84%,差异具有统计学意义(P<0.05)。行活检钳钳除术患者的并发症发生率均低于行氩气刀烧灼术、高频电切术、圈套器勒除术、注射后高频电切术、内镜下黏膜切除术(EMR)/内镜黏膜下剥离术(ESD)患者,行氩气刀烧灼术、高频电切术、圈套器勒除术、注射后高频电切术患者的并发症发生率均低于行EMR/ESD患者,差异具有统计学意义(P<0.05)。结论 结肠息肉内镜下治疗术后并发症的发生与患者年龄、是否有手术史、息肉数目、不同操作方式等因素有关,患者年龄越大、术前有手术史、多发息肉等术后并发症发生率较高,EMR/ESD术后并发症发病率明显高于其他操作方法。因此,合理选择病例、根据患者及结肠息肉的具体情况选择合适的操作方式可以有效降低和防止并发症的发生。Objective To analyze the occurrence of complications after endoscopic therapy of colonic polyps.Methods 2156 patients with colon polyps who underwent painless electronic colonoscopy and endoscopic treatment were observed,and the postoperative complications were observed,and the postoperative complications were compared among patients with different gender,age,surgical history,number of polyps and operation mode.Results Among the 2156 patients,95 cases(4.41%)had complications,including 36 cases(1.67%)of bleeding,4 cases(0.19%)of perforation,34 cases(1.58%)of abdominal pain,21 cases(0.97%)of infection,and none of them died.There was no statistically significant difference in the postoperative complication rate between different genders(P>0.05).The postoperative complication rate in patients aged≥60 years was 5.62%,which was higher than 3.55%in patients aged<60 years,and the difference was statistically significant(P<0.05).The postoperative complication rate in patients with surgery history was 8.53%,which was higher than 4.14%in patients without surgery history,and the difference was statistically significant(P<0.05).The postoperative complication rate of patients with≥2 polyps was 4.86%,which was higher than 1.84%of patients with 1 polyp,and the difference was statistically significant(P<0.05).The complication rates of patients who underwent biopsy forceps were lower than those who underwent argon cautery,high-frequency electrosurgery,snare excision,post-injection high-frequency electrosurgery,and endoscopic mucosal resection(EMR)/endoscopic submucosal dissection(ESD)patients;the complication rates of patients undergoing argon cautery,high-frequency electrosurgery,snare excision,and post-injection high-frequency electrosurgery were lower than those of patients undergoing EMR/ESD;all the differences were statistically significant(P<0.05).Conclusion The occurrence of complications after endoscopic therapy of colonic polyps is closely related to patient's age,whether there is a history of surgery,the number of po

关 键 词：结肠息肉 内镜下治疗 并发症 

分 类 号：R656.9[医药卫生—外科学]