175例结肠镜诊断和治疗结肠息肉的临床分析

Clinical analysis of colonoscope in diagnosis and treatment of colonic polyps (175 cases)

摘要:

目的??分析结肠息肉大小及分布特点，探讨色素结肠镜对结肠良性息肉的诊断及氩离子体凝固术（APC）、高频电凝电切术、内镜黏膜切除术（EMR）和钛夹术治疗良性息肉的临床疗效。方法?收集2015年12月-2016年6月在该院消化科住院行内镜及病理诊断为良性结肠息肉且行治疗的175例患者资料。结果?通过普通内镜和染色内镜检查，结肠良性息肉以单发性息肉为多；结肠在多部位有多发息肉类型为多；左半结肠中的直肠和乙状结肠息肉数较多且息肉直径较小，右半结肠中的升结肠息肉较少且直径较大，色素内镜有助于微小息肉和小息肉的诊断，染色检查提高了结肠多发息肉的检出率。结论?色素内镜可以提高息肉检出率，尤其是多发息肉检出率，减少漏诊率，有助于良性息肉的鉴别诊断；依据结肠单发和多发息肉结合息肉大小选择APC、高频电凝电切术或者EMR其中一种内镜治疗或联合2种内镜治疗方法，疗效明确、手术安全，以APC息肉切除术最常用。

Abstract:

Objective?To analyze the characteristic and distribution of colonic polyps and investigate the diagnosis of colorectal benign polyps for chromoendoscopy and curative effect of argon plasma coagulation, High frequency electric knife electric coagulation, EMR, Titanium clips treating Colorectal benign polyps.?Methods?175 patients of benign colorectal polyps of endoscopic diagnosis combined with pathology and treated were collected from December 2015 to June 2016.?Results?by ordinary and staining endoscopy, solitary polyp quantity and multiple polyps types in many segments for colon were more. Which the polyps quantity of rectum and sigmoid colon were more and polyp diameter was smaller in the left colon, the polyps quantity of ascending colon were less and polyp diameter was larger in the right colon. Pigment endoscopy was conduce to diagnose the micro-polyp. Chromoscopy enhanced the detection of multiple polyps in the colon.?Conclusions?Staining endoscopy is improved the multiple polyps detection rate and reduce omission diagnose rate, to profit the differential diagnosis of benign polyps, according to the solitary polyp and multiple polyps combined with polyp size in colon, which select the one of APC, high-frequency electric coagulation electric cut and EMR or two kinds of therapeutic endoscopy, therapeutic endoscopy is efficacy and safety technique and the most of APC.