冷圈套与热圈套切除结直肠6~9 mm息肉的疗效和安全性  

Efficacy and safety of cold snare versus hot snare for resection of 6-9 mm colorectal polyps

作　　者：蒋远健 刘杰民[1] 成绍敏 杨松[1] JIANG Yuanjian;LIU Jiemin;CHENG Shaomin;YANG Song(Department of Endoscopy,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院内镜科,贵州贵阳550002

出　　处：《贵州医科大学学报》2023年第8期938-944,共7页Journal of Guizhou Medical University

基　　金：贵州省高层次创新型人才项目资助(黔科合平台人才〔2020〕6016)。

摘　　要：目的对比冷圈套息肉切除术(CSP)和热圈套息肉切除术(HSP)治疗结直肠小息肉的有效性和安全性。方法以行内镜治疗的结直肠息肉(直径6~9 mm)患者194例为研究对象,随机分为CSP组97例(息肉145枚)、HSP组97例(息肉109枚),记录两组患者息肉部位、形状、大小、术中情况(手术时间、钛夹使用率、完全切除率)、并发症情况(即时出血率、延迟出血率、肠穿孔率等)、息肉切除术后腹痛的变化及满意度。结果两组患者的性别、年龄、息肉大小、部位、形态、病理类型等比较,差异无统计学意义(P>0.05);CSP组完全切除率与HSP组比较,差异无统计学意义(P>0.05);HSP组息肉切除的手术时间长于CSP组,差异有统计学意义(P<0.05);CSP组即时出血率明显高于HSP组,差异有统计学意义(P=0.001);息肉切除术后24 h,与HSP组比较,CSP组患者的腹痛率明显降低,差异有统计学意义(P=0.022);CSP组患者对手术的满意度明显好于HSP组,差异有统计学意义(P=0.030);两组患者均未出现肠穿孔等严重并发症。结论CSP对于6~9 mm的结直肠息肉具有较好的疗效及安全性。Objective To compare the efficacy and safety of cold snare polypectomy(CSP)and hot snare polypectomy(HSP)in the treatment of small colorectal polyps.Methods A total of 194 patients with colorectal polyps(diameter:6-9 mm)who received endoscopic treatment were selected as the subjects,and randomly divided into in CSP group(97 cases with 145 polyps)and HSP group(97 cases with 109 polyps).The changes of polyp site,shape,size,intraoperative(operation time,titanium clip utilization rate,complete resection rate),complications(immediate bleeding rate,delayed bleeding rate,intestinal perforation rate,etc.),abdominal pain,and satisfaction after polypectomy were compared between the two groups.Results There was no difference between CSP group and HSP group in sex,age,polyp size,location,morphology and pathological type(P>0.05);The complete resection rate of CSP was similar to that of HSP,but the difference was not statistically significant(P>0.05);The operative time of polyp removal with HSP was significantly longer than that with CSP,and the difference was statistically significant(P<0.05);The immediate bleeding rate was higher in CSP group than in HSP group,and the difference was statistically significant(P=0.001);One hour after polypectomy,abdominal pain in CSP group was similar to that in HSP group,but 24 h later,abdominal pain of CSP group was significantly reduced,compared with that of HSP group.The difference was statistically significant(P=0.022).The satisfaction of CSP group was significantly better than that of HSP group,and the difference was statistically significant(P=0.030).No serious complications such as intestinal perforation occurred in both groups.Conclusion The results demonstrated that CSP has better efficacy and safety for colorecta l polyps of 6-9 mm.

关 键 词：结直肠 息肉 冷圈套息肉切除术 热圈套息肉切除术 腹痛 

分 类 号：R574.62[医药卫生—消化系统]