冷圈套内镜下黏膜切除术在治疗结直肠小息肉中的应用  

Application of cold snare endoscopic mucosal resection in treating small colorectal polyps

作　　者：丁飞 郭浩 祁崇斌 徐少军 李峰[1] 伍平 董青[1] DING Fei;GUO Hao;QI Chong-bin;XU Shao-jun;LI Feng;WU Ping;DONG Qing(Department of Gastroenterology,Anqing First People's Hospital of Anhui Medical University,Anqing Ahhui 246003,China)

机构地区：[1]安徽医科大学附属安庆第一人民医院消化内科,安徽安庆246003

出　　处：《局解手术学杂志》2025年第4期333-337,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨冷圈套内镜下黏膜切除术(CS-EMR)在治疗6~9 mm结直肠小息肉中的应用效果。方法选择2022年3月至2023年8月我院收治的82例结肠小息肉患者,按照不同术式分为观察组(采用CS-EMR)45例和对照组[采用热圈套内镜下黏膜切除术(HS-EMR)]37例。对比2组患者临床疗效、息肉切除情况、息肉完整切除率、围术期指标及并发症发生情况。结果术后随访1个月,观察组患者治疗有效率高于对照组(P<0.05);2组患者切除息肉情况和围术期指标比较差异均无统计学意义(P>0.05);2组患者不同病理类型的息肉完整切除率和总完整切除率比较差异均无统计学意义(P>0.05);观察组患者迟发性出血发生率和内镜下止血率低于对照组(P<0.05)。结论CS-EMR治疗6~9 mm结直肠小息肉的完整切除率与HS-EMR相当,且CS-EMR的疗效更佳,可降低围术期出血风险,安全性更高。Objective To investigate the application effect of cold snare endoscopic mucosal resection(CS-EMR)in the treatment of 6 to 9 mm colorectal small polyps.Methods A total of 82 patients with small colonic polyps in our hospital from March 2022 to August 2023 were collected and divided into the observation group(45 cases received CS-EMR)and the control group[37 cases received hot snare endoscopic mucosal resection(HS-EMR)]according to different surgical methods.The clinical efficacy,polyp resection status,complete polyp resection rate,perioperative indicators and occurrence of complications were compared between the two groups.Results Follow-up for 1 month after operation,the effective rate of treatment in the observation group was higher than that in the control group(P<0.05).There was no statistically significant difference in the polyp resection status or perioperative indicators between the two groups(P>0.05).There was no statistically significant difference in the complete polyp resection rates of patients with different pathological types or total complete resection rate between the two groups(P>0.05).The incidence of delayed bleeding and endoscopic hemostasis rate in the observation group were lower than those in the control group(P<0.05).Conclusion The complete resection rate of 6~9 mm colorectal polyps through CS-EMR was comparable to that of HS-EMR,and CS-EMR has a better efficacy and lower risk of perioperative bleeding,along with higher safety.

关 键 词：内镜 冷圈套内镜下黏膜切除术 结直肠 息肉 出血 

分 类 号：R574.6[医药卫生—消化系统]