冷热圈套器联合黏膜下注射切除结直肠息肉的临床对比研究  

A clinical study comparing the effectiveness and safety of cold versus hot snare endoscopic mucosal resection for colorectal polyps

作　　者：邵金曼 邓楠 雍颖 吕春梅 张连超 胡菱 SHAO Jinman;DENG Nan;YONG Ying;LYU Chunmei;ZHANG Lianchao;HU Ling(Beijing Xiaotangshan Hospital,Beijing 102211,China)

机构地区：[1]北京小汤山医院综合内科消化内镜中心,102211

出　　处：《中国老年保健医学》2024年第5期138-141,共4页Chinese Journal of Geriatric Care

摘　　要：目的本研究旨在比较内镜下采用冷圈套联合黏膜下注射息肉切除术(CS-EMR)与热圈套联合黏膜下注射息肉切除术(HS-EMR)治疗直径<10mm结直肠息肉的有效性及安全性。方法回顾性分析2022年9月至2023年3月于北京小汤山医院接受治疗的46例结直肠息肉患者的临床资料,根据手术方式将其分为CS-EMR组(26例)和HS-EMR组(20例)。比较两组在息肉大小、位置、形态、组织学分类、完全切除率、金属夹使用数量、并发症发生率等方面的差异。结果两组患者在年龄、性别、肠镜指征方面无显著差异。两组息肉在大小、位置以及组织学分类上无统计学差异(P>0.05),在形态方面有统计学差异(P=0.019)。两组的完全切除率相似。两组金属夹的平均使用数量差异无统计学意义(P=0.411),但CS-EMR组的息肉平均手术费用低于HS-EMR组。两组均未发生穿孔,但HS-EMR组出现1例需要内镜再干预的延迟出血。结论CS-EMR与HS-EMR在切除直径<10mm结直肠息肉上有相似的完全切除率,但CS-EMR术后出血风险较低,且具有更高的经济效益比。Objective The purpose of this study is to compare the efficacy and safety of cold versus hot snare endoscopic mucosal resection in the treatment of colorectal polyps with diameter less than 10mm.Methods A total of 46 patients treated at Beijing Xiaotangshan Hospital between September 2022 and March 2023 were included in this study.The patients were divided into the CS-EMR group(n=26)and the HS-EMR group(n=20).Between the two groups,the polyp size,location,morphology,histological classification,complete resection rate,number of prophylactic clips used,and incidence of complications were compared.Results There were no significant differences in age,sex,or indication of colonoscopy between the two groups.The polyps in terms of size,position,and histological classification showed no significant differences.There was a significant difference in morphology(P=0.019),which showed that it had statistical significance.Total removal rates were similar in both groups.There were no significant differences in the number of prophylactic clips used(P=0.411),but the average cost of polyp removal was lower in the CS-EMR group compared to the HS-EMR group.No cases of perforation were observed in either group,but there was one case of delayed bleeding requiring endoscopic reintervention in the HS-EMR group.Conclusion CS-EMR and HS-EMR demonstrate similar complete resection rates for colorectal polyps sized less than 10 mm in diameter.However,CS-EMR has a lower risk of postoperative bleeding and higher economic benefits compared to HS-EMR.

关 键 词：肠息肉 冷圈套器 热圈套器 黏膜下注射 完全切除率 并发症 

分 类 号：R574[医药卫生—消化系统]