内镜下高频电切术、氩离子束凝固术及黏膜切除术治疗结肠息肉的有效性和安全性

Clinical efficacy and safety of endoscopic high-frequency electroexcision, argon plasma coagulation and mucosal resection in treatment of colon polyps

摘要:

目的 探讨和分析内镜下高频电切术、氩离子束凝固术（APC）及黏膜切除术在结肠息肉治疗中的应用价值。方法 选取2017年6月－2018年6月该院行内镜下手术治疗的310例（息肉442枚）结肠息肉患者作为研究对象，根据患者病情分为内镜下高频电切术组150例（息肉203枚）、内镜下APC组40例（息肉66枚）和内镜下黏膜切除术（EMR）组120例（息肉173枚），并分别对3组患者的临床治疗情况、生活质量改善情况和并发症发生情况进行比较和分析。结果 内镜下APC组总有效率95.00%和EMR组总有效率96.67%均较内镜下高频电切术组明显提高，而无效率5.00%和3.33%均明显降低，两两比较，差异有统计学意义（P < 0.05）。内镜下APC组和EMR组主观症状、生理功能、心理情绪、社会活动和消化病生存质量指数（GLQI）总分均较内镜下高频电切术组明显提高，两两比较，差异有统计学意义（P < 0.05）。EMR组患者出血和穿孔等并发症总发生率（0.83%）较内镜下高频电切术组明显降低，两组比较，差异有统计学意义（P < 0.05）。EMR组患者出血和穿孔等并发症总发生率较内镜下APC组略有降低，两组比较，差异无统计学意义（P > 0.05）。结论 内镜下APC和EMR在结肠息肉患者临床疗效、生存质量和安全性方面均优于内镜下高频电切术。

Abstract:

Objective To probe into the application value in treatment of endoscopic high-frequency electroexcision, argon plasma coagulation and mucosal resection for patients with colon polyps.Methods From June 2017 to June 2018, 310 patients (442 polyps) with endoscopic surgery were selected as subjects in our hospital. According to the patient's condition, the patients were divided into endoscopic high-frequency electroexcision group of 150 cases (203 polyps), endoscopic argon plasma coagulation group of 40 cases (66 polyps), endoscopic mucosal resection group 120 cases (173 polyps). The clinical treatment effect, quality of life improvement, and complications of the patients in three groups were compared and analyzed.Results Compared with endoscopic high-frequency electroexcision group, the patients in endoscopic argon plasma coagulation group, the total effective rate was 95.00%, the patients in endoscopic mucosal resection group, the total effective rate was 96.67%, there were increased significantly, while the inefficiency rate was 5.00% and 3.33%, there were reduced significantly, the differences were significant statistically (P < 0.05). Compared with the endoscopic high-frequency electroexcision group, the patients in endoscopic argon plasma coagulation group and endoscopic mucosal resection group, the subjective symptoms, physiological functions, psychological emotions, social activities and GLQI total scores were improved significantly, the differences were significant statistically (P < 0.05). Compared with the endoscopic high-frequency electrosurgery group, the patients in endoscopic mucosal resection group, the total incidence of complications, included bleeding and perforation was 0.83%, there were reduced significantly, the differences were significant statistically (P < 0.05). Compared with the endoscopic argon plasma coagulation group, the total incidence of complications, included bleeding and perforation was slightly reduced, after statistical analysis, the differences were not significant statistically (P > 0.05).Conclusion Endoscopic argon plasma coagulation and endoscopic mucosal resection for the improvement of clinical efficacy, improvement of quality of life, and safety for patients with colon polyps, superior toendoscopic high-frequency electricexcision.