内镜下黏膜切除术治疗结肠息肉效果及复发相关因素分析  

Effect of Endoscopic Mucosal Resection in the Treatment of Colon Polyps and Analysis of Recurrence-related Factors

作　　者：王仟慧 徐长龙 李发全 董鳞 WANG Qianhui;XU Changlong;LI Faquan;DONG Lin(Department of Gastroenterology,Tianchang People's Hospital,Tianchang,Anhui 239300,China;Department of Oncology,Tianchang People's Hospital,Tianchang,Anhui 239300,China)

机构地区：[1]天长市人民医院消化内科,安徽天长239300 [2]天长市人民医院肿瘤科,安徽天长239300

出　　处：《临床误诊误治》2024年第8期76-80,共5页Clinical Misdiagnosis & Mistherapy

基　　金：安徽省重点研究与开发计划项目(201904407020060)。

摘　　要：目的探讨内镜下黏膜切除术(EMR)治疗结肠息肉的效果,分析其复发相关因素。方法选取2020年10月—2023年12月收治的结肠息肉120例,根据手术方式不同将其分为EMR组(采用EMR,69例)和电切术组(采用内镜下高频电切术,51例)2组。比较2组手术相关指标、临床疗效、并发症和复发情况;采用单因素和多因素Logistic回归分析探讨影响EMR术后结肠息肉复发的相关因素。结果EMR组手术时间、胃肠功能恢复时间和住院时间均短于电切术组,术中出血量少于电切术组(P<0.01)。术后2个月,EMR组总有效率(67/69,97.10%)高于电切术组(44/51,86.27%)(P<0.05);EMR组并发症发生率(2/69,2.90%)低于电切术组(7/51,13.73%)(P<0.05)。术后6个月,2组复发率比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,体质量指数和息肉直径为影响EMR术后结肠息肉复发的独立危险因素(P<0.01)。结论EMR治疗结肠息肉效果良好,利于改善手术相关指标,减少术后并发症。体质量指数和息肉直径为影响EMR术后结肠息肉复发的独立危险因素。Objective To investigate the effect of endoscopic mucosal resection(EMR)in the treatment of colon polyps and to analyze recurrence-related factors.Methods In total,120 patients with colon polyps treated from October 2020 to December 2023 were selected and divided into two groups according to different surgical methods:EMR group(using EMR,n=69)and electrotomy group(using endoscopic high-frequency electrotomy,n=51).The operation-related indexes,clinical efficacy,complications and recurrence were compared between the two groups.Univariate analysis and multivariate Logistic regression analysis were used to investigate the related factors affecting colon polyp recurrence after EMR.Results The duration of operation,length of hospital stay and time to gastrointestinal function recovery in EMR group were shorter than those in electrotomy group,and the amount of intraoperative blood loss was less than that in electrotomy group(P<0.01).At two months after operation,the total effective rate in EMR group(67/69,97.10%)was higher than that in electrotomy group(44/51,86.27%)(P<0.05).The incidence of complications in EMR group(2/69,2.90%)was lower than that in electrotomy group(7/51,13.73%)(P<0.05).At six months after operation,there was no significant difference in recurrence rate between the two groups(P>0.05).Multivariate logistic regression analysis showed that body mass index and polyp diameter were independent risk factors for colon polyp recurrence after EMR(P<0.01).Conclusion EMR is effective in the treatment of colon polyp,which is conducive to improving operation-related indexes and reducing postoperative complications.BMI and polyp diameter were independent risk factors for colon polyp recurrence after EMR.

关 键 词：内镜下黏膜切除术 内镜下高频电切术 结肠息肉 手术相关指标 治疗结果 复发 并发症 多因素LOGISTIC回归分析 

分 类 号：R735.35[医药卫生—肿瘤]