冷圈套器息肉切除术与内镜下黏膜切除术用于抗凝患者结肠息肉切除的疗效及安全性  

Efficacy and safety of cold snare polypectomy and endoscopic mucosal resection in colon polypectomy for anticoagulation patients

作　　者：陈卓锋 黄筱霞 徐娟 CHEN Zhuofeng;HUANG Xiaoxia;XU Juan(Department of Gastroenterology,Lecong Hospital of Shunde Foshan,Guangdong,Foshan 528315,China)

机构地区：[1]广东省佛山市顺德区乐从医院消化内科,广东佛山528315

出　　处：《中国医药科学》2023年第22期162-166,共5页China Medicine And Pharmacy

基　　金：广东省佛山市科技计划项目(2020001004260)。

摘　　要：目的探究冷圈套器息肉切除术(CSP)与内镜下黏膜切除术(EMR)用于抗凝患者结肠息肉切除的疗效及安全性。方法选择2021年3月至2022年2月佛山市顺德区乐从医院收治的行结肠息肉切除的患者60例,采用随机数表法分为CSP组(CSP术式治疗)与EMR组(EMR术式治疗),每组各30例。比较两组手术情况、息肉回收成功率、完全切除率、复发率、并发症总发生率,并检测其血清炎症因子水平的变化。结果CSP组平均切除时间为(3.24±0.92)min、内镜操作时间为(14.25±2.75)min短于EMR组的(5.97±1.89)min、(24.32±2.56)min,差异有统计学意义(P<0.05)。CSP组住院费用为(1812.79±200.37)元低于EMR组的(3427.87±350.68)元,差异有统计学意义(P<0.05)。两组患者息肉直径[(6.38±2.10)mmvs.(6.46±2.14)mm]比较,差异无统计学意义(P>0.05)。手术1 h后,两组血清炎症因子白细胞介素-8(IL-8)、白细胞介素-12(IL-12)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平较手术前升高,差异有统计学意义(P<0.05);且CSP组IL-8、IL-12、IL-6、IL-1β低于EMR组,差异有统计学意义(P<0.05)。CSP组息肉回收成功率为96.67%、完整切除率为93.33%、复发率为3.33%与EMR组的90.00%、100.00%、0比较,差异无统计学意义(P>0.05)。两组都有即时出血发生,CSP组即时出血2例,EMR组即时出血3例,且EMR组出现1例延迟出血,两组手术中、手术后均无穿孔现象出现。两组并发症总发生率13.33%、6.67%比较,差异无统计学意义(P>0.05)。结论与EMR相比,CSP用于抗凝患者结肠息肉切除,具有手术时间短、治疗费用低等优势,且不会提高复发率和并发症发生率,值得临床推广应用。Objective To explore the efficacy and safety of cold snare polypectomy(CSP)and endoscopic mucosal resection(EMR)in colon polypectomy for anticoagulated patients.Methods A total of 60 patients who underwent colon polypectomy in Lecong Hospital of Shunde Foshan from March 2021 to February 2022 were randomly divided into CSP group(receiving CSP operation)and EMR group(receiving EMR operation),with 30 patients in each group.The operation situation,the success rate of polyp recovery,the complete resection rate,the recurrence rate and the incidence of complications were compared,and the changes of serum inflammatory factors were detected.Results The average resection time(3.24±0.92 minutes)and endoscopic operation time(14.25±2.75)minutes in the CSP group were lower than those in the EMR group(5.97±1.89)minutes and(24.32±2.56)minutes,with statistically significant differences(P<0.05).The hospitalization expense(1812.79±200.37)yuan in the CSP group was lower than that in the EMR group(3427.87±350.68)yuan,with statistically significant difference(P<0.05).There was no significant difference in the size of polyps between the two groups([6.38±2.10]mm vs.[6.46±2.14]mm)(P>0.05).One hour after the operation,the levels of serum inflammatory factors such as interleukin-8(IL-8),interleukin-12(IL-12),interleukin-6(IL-6)and interleukin-1β(IL-1β)in the two groups were higher than those before the operation,with statistically significant difference(P<0.05).The levels of IL-8,IL-12,IL-6 and IL-1βin the CSP group were lower than those in EMR group,with statistically significant difference(P<0.05).There were no significant differences in the successful rate of polyp recovery(96.67%vs.90%),the complete resection rate(93.33%vs.100%)and the recurrence rate(3.33%vs.0)between the CSP group and the EMR group(P>0.05).Immediate bleeding occurred in both groups,including 2 cases in the CSP group and 3 cases in the EMR group,and there was 1 case of delayed bleeding in the EMR group.There was no perforation during and after operation in

关 键 词：结肠息肉 冷圈套器息肉切除术 内镜下黏膜切除术 抗凝患者 

分 类 号：R574.62[医药卫生—消化系统]