冷圈套器在应用抗凝药老年患者结直肠小息肉切除中的效果分析  

Effect of cold snare on the resection of small colorectal polyps in elderly patients treated with anticoagulant drugs

作　　者：李超[1] 焦娇 王世卉 段志英[2] 田博[2] 褚茜茜 赵云霞[3] 韩双双[1] LI Chao;JIAO Jiao;WANG Shihui(Second Department of Gastroenterology,the First Hospital of Hebei Medical University,Hebei,Shijiazhuang 050031,China;不详)

机构地区：[1]河北医科大学第一医院胃肠病诊疗二科,石家庄市050031 [2]河北医科大学第一医院胃肠病诊疗四科,石家庄市050031 [3]河北医科大学第一医院内镜中心,石家庄市050031

出　　处：《河北医药》2024年第21期3254-3258,共5页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:ZD20140126)。

摘　　要：目的对比冷圈套器息肉切除术(cold snare polypectomy,CSP)、高频电刀息肉切除术(hot snare polypectomy,HSP)二种内镜治疗方法在口服抗凝药老年患者中切除结直肠小息肉的应用价值。方法选取2013年1月至2018年6月内镜中心行结直肠息肉内镜下治疗的老年患者90例,随机分为CSP组和HSP组,每组45例,其中,冷圈套切除息肉共58枚,高频电刀切除息肉共62枚。比较2组的单个息肉切除时间、一次完整切除率、术中术后出血情况及1年复发情况。结果2组息肉大小、完整切除率比较,差异无统计学意义(P>0.05)。CSP组切除时间低于HSP组,差异有统计学意义(P<0.05)。CSP组术中出血率为3.45%(2/58),HSP组为1.61%(1/62),2组差异无统计学意义(P>0.05);CSP组迟发出血率为1.72%(1/58),HSP组为12.90%(8/62),CSP组低于HSP组,差异有统计学意义(P<0.05)。2组均无无迟发性穿孔病例。2组住院时间比较,差异无统计学意义(P>0.05),CSP组术后1年复发率为1.72%(1/58),HSP组为6.45%(4/62),HSP组高于CSP组(P<0.05)。CSP组治疗费用低于HSP组,差异有统计学意义(P<0.05)。CSP组术后1年结肠息肉复发率低于HSP组(P<0.05)。术后1年随访过程中2组患者腹部症状腹痛、大便不成形比较,差异无统计学意义(P>0.05)。结论冷圈套器在应用抗凝药老年患者结直肠小息肉切除的过程中,有效果确切、安全快速、副损伤小的优势,值得临床推广。Objective To compare the application value of two endoscopic treatment methods,cold snare polypectomy(CSP)and hot snare polypectomy(HSP),in the resection of small colorectal polyps in elderly patients treated with oral anticoagulants.Methods Between January 2013 and June 2018,90 elderly patients with endoscopic treatment of colorectal polyps at the endoscopy center were selected and randomly divided into the CSP group and the HSP group,with 45 cases per group.Among the eligible patients,58 and 62 polyps were removed by the CSP and the HSP,respectively.The time of single polyp resection(preparation to complete resection),complete resection rate,intraoperative and postoperative bleeding,and 1-year recurrence of the two groups were compared and analyzed.Results There were no significant differences in the polyp size and complete resection rate between the two groups(P>0.05).The resection time in the CSP group was significantly shorter than that of the HSP group(P<0.05).The intraoperative bleeding rate in the CSP group was comparable to that of the HSP group(3.45%[2/58]vs 1.61%[1/62],P>0.05).The delayed bleeding rate in the CSP group was significantly lower than that of the HSP group(1.72%[1/58]vs 12.90%[8/62],P<0.05).There were no cases of delayed perforation in both groups.There was no significant difference in the length of stay between groups(P>0.05).The 1-year recurrent rate was significantly lower in the CSP group than that of HSP group(1.72%[1/58]vs 6.45%[4/62],P<0.05).The treatment cost of the CSP group was significantly lower than that of the HSP group(P<0.05).The 1-year recurrent rate of colon polyps in the CSP group was significantly lower than that of the HSP group(P<0.05).During the 1-year follow-up,there were no significant differences in abdominal symptoms,abdominal pain,and unformed stool between the two groups(P>0.05).Conclusion CSP has the advantages of precise effect,high safety,rapid procedures and less trauma in the resection of small colorectal polyps in elderly patients treated with anticoagula

关 键 词：冷圈套器息肉切除术 高频电刀息肉切除术 结直肠息肉 老年患者 抗凝药物 

分 类 号：R472.91[医药卫生—护理学]