结肠镜辅助下EMR、CSP和RFA术治疗直径<1cm结直肠息肉的疗效和安全性比较  

Comparison of efficacy and safety of colonoscope-assisted EMR,CSP and RFA in the treatment of colorectal polyps<1cm in diameter

作　　者：杨建波 马欢 黄小梅 刘华柱 Yang Jianbo;Ma Huan;Huang Xiaomei;Liu Huazhu(Department of Gastroenterology,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang Sichuan Province 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院消化内科,四川绵阳621000

出　　处：《中华普外科手术学杂志(电子版)》2025年第1期76-79,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省卫生厅科研课题(20PJ263)。

摘　　要：目的探究结肠镜辅助下内镜下黏膜切除术(EMR)、圈套器冷切除术(CSP)和射频消融术(RFA)治疗直径<1cm结直肠息肉患者的疗效和安全性。方法前瞻性选取2020年1月至2022年1月收治的297例结直肠息肉患者,按照随机数字表法分为EMR组(n=99例)、CSP组(n=99例)、RFA组(n=99例),3组分别采用EMR、CSP、RFA治疗。选用SPSS23.0软件分析数据,疗效行秩和检验,并发症发生情况等采用χ^(2)检验,围手术期指标、炎性指标等计量资料以(x±s)表示,两组间行t检验,多组间行单因素方差分析。P<0.05为差异有统计学意义。结果术后2周,CSP组与RFA组治疗总有效率比较,差异无统计学意义(P>0.05);CSP组、RFA治疗总有效率均高于EMR组(P<0.05)。RFA组、CSP组术中出血量、手术时间及术后2d视觉模拟评分法(VAS)评分均低于EMR组(P<0.05),RFA组与CSP组比较差异无统计学意义(P>0.05)。RFA组、CSP组术后2d C反应性蛋白(CRP)、白细胞介素-6(IL-6)水平均低于EMR组(P<0.05),但RFA组与CSP组相比,差异无统计学意义(P>0.05)。CSP组、RFA组患者术后并发症总发生率低于EMR组(P<0.05);RFA组术后并发症总发生率低于CSP组,但差异无统计学意义(P>0.05)。结论与EMR相比,CSP、RFA术治疗直径<1cm结直肠息肉的疗效更高,患者恢复更快,炎性因子水平更低,并发症较少,安全性更高。Objective To explore the efficacy and safety of colonoscopy-assisted endoscopic mucosal resection(EMR),cold snare resection(CSP)and radiofrequency ablation(RFA)in the treatment of colorectal polyps<1cm in diameter.Methods A total of 297 patients with colorectal polyps admitted from January 2020 to January 2022 were prospectively selected and divided into EMR group(n=99 cases),CSP group(n=99 cases)and RFA group(n=99 cases)according to random number table method.The three groups were treated with EMR,CSP and RFA,respectively.SPSS23.0 software was used to analyze the data and Rank Sum test was performed.The incidence of complications was measured byχ^(2) test,perioperative indexes and inflammatory indexes were expressed as(x±s),t test was performed between two groups,and One-way ANOVA was performed between multiple groups.P<0.05 was considered statistically significant.Results At 2 weeks after operation,there was no significant difference in total effective rate between CSP group and RFA group(P>0.05).The total effective rate of CSP group and RFA group was higher than EMR group(P<0.05).The intraoperative blood loss,operation time and 2d visual analogue VAS score in RFA and CSP groups were lower than those in EMR group(P<0.05).There was no significant difference between RFA group and CSP group(P>0.05).The 2d C-reactive protein(CRP)and interleukin-6(IL-6)levels in RFA group and CSP group were lower than those in EMR group(P<0.05),but there was no significant difference between RFA group and CSP group(P>0.05).The total incidence of postoperative complications in CSP and RFA groups was lower than that in EMR group(P<0.05).The total incidence of postoperative complications in RFA group was lower than that in CSP group,but the difference was not statistically significant(P>0.05).Conclusion Compared with EMR,CSP and RFA have higher efficacy in the treatment of colorectal polyps<1cm in diameter,faster recovery of patients,lower levels of inflammatory factors,fewer complications,and higher safety.

关 键 词：结直肠息肉 结肠镜 内镜下黏膜切除术 圈套器冷切除术 射频消融术 

分 类 号：R735.34[医药卫生—肿瘤]