内镜下冷圈套息肉切除术在老年患者结直肠小息肉治疗中的应用  

Application of endoscopic cold snare polypectomy in removing small colorectal polyps in elderly patients

作　　者：张婷婷 吴兆映 ZHANG Tingting;WU Zhaoying(Department of Gastroenterology,The Second Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)

机构地区：[1]皖南医学院第二附属医院消化内科,安徽芜湖241001 [2]皖南医学院第二附属医院胃肠外科,安徽芜湖241001

出　　处：《皖南医学院学报》2025年第2期156-158,171,共4页Journal of Wannan Medical College

基　　金：安徽省卫生健康科研项目(AHWJ2023A30148)。

摘　　要：目的:探讨内镜下冷圈套息肉切除术(CSP)在老年患者结直肠小息肉治疗中的应用价值。方法:选取2023年3月~2024年3月在皖南医学院第二附属医院治疗的结直肠小息肉老年患者(年龄≥59岁,息肉大小5~10 mm)202例(共236枚息肉),根据治疗方法选择分为常规热圈套内镜黏膜切除术(HS-EMR)组和CSP组,比较两组患者的一般资料、息肉切除时间、完整切除率及并发症发生率等。结果:两组均有较高的息肉完整切除率及回收率,CSP组术中出血率较HS-EMR组偏高,而手术时间、钛夹使用率及术后腹部不适发生率低于HS-EMR组,差异有统计学意义(P<0.05)。结论:CSP在老年患者5~10 mm结直肠息肉治疗中安全、有效,尤其是伴有慢性病需长期服用抗凝抗血小板药物的老年患者,且缩短了手术时间、节约了医疗资源,值得临床推广应用。Objective:To assess the value of applying endoscopic cold snare polypectomy(CSP)in removing small colorectal polyps in elderly patients.Methods:202 elderly patients(aged≥59 years)with small colorectal polyps(5-10 mm in size,236 polyps in total)treated in our hospital were included from March 2023 to March 2024,and divided into the control group(hot snare endoscopic mucosal resection,HS-EMR group)and the observational group(cold snare polypectomy,CSP group)based on the treatment modality.The two groups of patients were compared in terms of general information,polyp resection time,complete resection rate,and incidence of complications.Results:Both the CSP group and the HS-EMR group achieved high rates of complete polyp resection and retrieval.The intraoperative bleeding rate in the CSP group was higher than in the HS-EMR group,while the operative time,use of titanium clips,and incidence of postoperative abdominal discomfort were significantly lower in the CSP group.The difference was significant(P<0.05).Conclusion:Cold snare polypectomy is safe and effective for removing the small colorectal polyps sized 5-10 mm in the elderly patients,especially for those with chronic diseases who require long-term anticoagulant and antiplatelet medication.This technique is worthy of clinical recommendation because it can also shorten the operative time and save medical resources.

关 键 词：结直肠小息肉 老年患者 内镜下冷圈套息肉切除术 

分 类 号：R657.1[医药卫生—外科学] R592[医药卫生—临床医学]