无痛内镜下冷切除术在老年患者5～9 mm扁平无蒂结直肠息肉治疗中的临床应用价值

Clinical application of painless endoscopic cold resection in treatment of 5 ~ 9 mm flat sessile colorectal polyps in elderly patients

摘要:

目的 探讨无痛内镜下冷切除术在老年患者5～9 mm扁平无蒂结直肠息肉治疗中的临床应用价值。方法 选取在开封市人民医院内镜中心行无痛肠镜检查，发现扁平无蒂结直肠息肉且直径在5～9 mm的124例老年患者为研究对象，按照随机数表法分为研究组（n = 64）和对照组（n = 60）。研究组应用圈套器对息肉行冷切除治疗，对照组给予黏膜下注射使息肉抬举后，应用圈套器行高频电切除治疗。比较两组患者手术时间、术中出血量、一次性完整切除率、标本回收率、息肉病理类型、术后并发症及手术费用。结果 研究组手术时间较对照组短，手术费用较对照组少，术后并发腹胀的情况较对照组少，差异均有统计学意义（P < 0.05）；两组患者术中出血例数、一次性完整切除率、标本回收率、术后并发腹痛和出血比较，差异均无统计学意义（P > 0.05）。结论 无痛内镜下应用圈套器对5～9 mm扁平无蒂结直肠息肉行冷切除术，手术时间短，安全性高，并发症少，费用低，且避免了高频电对周围正常黏膜的损伤。

Abstract:

Objective To explore the clinical application value of painless endoscopic cold resection in treatment of 5 ~ 9 mm flat sessile colorectal polyps in elderly patients.Methods 124 elderly patients with flat sessile colorectal polyps with a diameter of 5 ~ 9 mm found by painless enteroscopy were randomly divided into study group (n = 64) and control group (n = 60). The study group was treated with trap for cold resection of polyps, and the control group was treated with high frequency electric resection after submucosal injection to lift the polyps. The operation time, intraoperative bleeding, one-time complete resection rate, specimen recovery rate, polyp pathological type, postoperative complications and operation cost were compared between the two groups.Results The operation time in the study group was shorter than that in the control group, the operation cost was less than that in the control group, the postoperative abdominal distension was less than that in the control group, the difference were statistically significant (P < 0.05); There were no significant difference in intraoperative bleeding, one-time complete resection rate, specimen recovery rate, postoperative abdominal pain and bleeding between the two groups (P > 0.05).Conclusion Cold resection of 5~9 mm flat sessile colorectal polyps with a snare under painless endoscopy has the advantages of short operation time, high safety, few complications and low cost, and avoids the damage of high-frequency electricity to the surrounding normal mucosa.