胃肠镜下高频电切联合氩离子电凝术治疗上消化道息肉疗效分析
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摘要
目的探讨胃肠镜下高频电切术(HFE)联合氩离子电凝术(APC)治疗上消化道息肉的临床应用效果及安全性。方法将2016年1月至2017年1月我院收治的98例上消化道息肉患者按手术方案的不同分为对照组和观察组,对照组46例患者采用胃肠镜下HFE联合MPC治疗,观察组52例患者采用胃肠镜下HFE联合APC治疗。比较2组患者手术时间、术后疼痛NRS评分、一次手术成功率及并发症发生率等。结果蒂息型、扁平型、广基型患者的手术时间、术后疼痛NRS评分比较,观察组少于对照组(P <0. 05);观察组一次手术成功率高于对照组(P <0. 05);观察组术后并发症发生率低于对照组,差异有统计学意义(P <0. 05)。结论胃肠镜下HFE联合APC可有效处理有蒂的蒂息型、扁平型上消化道息肉和无蒂的广基型上消化道息肉,具有较高的安全性,是一种治疗上消化道息肉的可行性手术方案。
Objective To explore the clinical application effect and safety of gastrointestinal endoscopic high frequency electrotomy( HFE) combined with argon plasma coagulation( APC) in the treatment of upper gastrointestinal polyps. Methods A total of 98 patients with upper gastrointestinal polyps in our hospital from January 2016 to January 2017 were divided into control group and observation group according to surgical menthods,46 cases in the control group were treated with HFE combined with microwave coagulation( MC) under gastrointestinal endoscopy,52 cases in the observation group were treated with HFE combined with APC under gastrointestinal endoscopy. The operation time,NRS score of postoperative pain,success rate of first surgery and incidence of complications between the two groups were compared.Results The operation time and NRS scores of the patients with pedunculated polyp,flat polyp and sessile colorectal polyp in the observation group were less than those in the control group( P < 0. 05). The success rate of first surgery in the observation group was higher than that in the control group( P < 0. 05). The incidence of complications in the observation group were lower than that in the control group,the difference was significant( P < 0. 05). Conclusion HFE combined with APC under gastrointestinal endoscopy is a feasible operation for patients of upper gastrointestinal polyps with high safety.
Objective To explore the clinical application effect and safety of gastrointestinal endoscopic high frequency electrotomy( HFE) combined with argon plasma coagulation( APC) in the treatment of upper gastrointestinal polyps. Methods A total of 98 patients with upper gastrointestinal polyps in our hospital from January 2016 to January 2017 were divided into control group and observation group according to surgical menthods,46 cases in the control group were treated with HFE combined with microwave coagulation( MC) under gastrointestinal endoscopy,52 cases in the observation group were treated with HFE combined with APC under gastrointestinal endoscopy. The operation time,NRS score of postoperative pain,success rate of first surgery and incidence of complications between the two groups were compared.Results The operation time and NRS scores of the patients with pedunculated polyp,flat polyp and sessile colorectal polyp in the observation group were less than those in the control group( P < 0. 05). The success rate of first surgery in the observation group was higher than that in the control group( P < 0. 05). The incidence of complications in the observation group were lower than that in the control group,the difference was significant( P < 0. 05). Conclusion HFE combined with APC under gastrointestinal endoscopy is a feasible operation for patients of upper gastrointestinal polyps with high safety.
引文
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[20]杨叶.糖尿病合并消化道息肉患者内镜下切除术的个体化治疗方案安全性分析[J].中国全科医学,2013,16(14):1667-1679.doi:10.3969/j.issn.1007-9572.2013.05.066.
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[22]孙华波.内镜下微波灼除术和高频电切术治疗消化道息肉效果比较[J].山东医药2015,55(45):57-60.doi:10.3969/j.issn.1002-266X.2015.45.021.
[2]艾尼·阿布都热依木,刘春明.内镜下高频电凝电切摘除大肠息肉160例[J].中华消化内镜杂志,2016,23(3):218-222.doi:10.3760/cma.j.issn.1007-5232.2006.03.022.
[3]Hongo M,Fujimoto K.Incidence and risk factor of fundic gland polyp and hyperplastic polyp in long-term proton pump inhibitor therapy:a prospective study in japan[J].J Gastroenterol,2015,45(6):618-624.doi:10.1007/s00535-010-0207-7.
[4]卢晨霞,施正君,王雪明.高频电切联合氩离子凝固术治疗消化道息肉[J].牡丹江医学院学报,2017,38(3):95-97.doi:10.23799/j.cnki.mdjyxyxb.2017.03.036.
[5]李小梅,李虹义,肖文华,等.癌症患者疼痛量表的应用[J].中国肿瘤临床,2016,16(24):1482-1486.doi:10.3969/j.issn.1000-8179.20131973.
[6]司秋霞.经胃镜消化道息肉高频电凝切除术的治疗及护理[J].现代医药卫生,2017,33(7):1088-1089.doi:10.3969/j.issn.1009-5519.2017.07.047.
[7]王莹,罗红来,厉琴,等.内镜下橡皮圈套扎与高频电切除术治疗消化道息肉的临床效果比较[J].湖南师范大学学报(医学版),2017,14(6):126-129.doi:10.3969/j.issn.1673-016X.2017.06.038.
[8]Winawer SJ,Zauber AG,Ho MN,et al.Prevention of colorectal cancer by colonoscopicpolypectomy.The National Polyp Study Workgroup[J].N Engl J Med,2016,329(27):1977-1981.doi:10.1056/NE-JM199312303292701.
[9]郑娟.胃镜下胃息肉电凝切除术的临床分析[J].中国社区医师,2016,32(14):52-54.doi:10.3969/j.issn.1007-614x.2016.14.29
[10]雷撼,沈寒放,张蔚东,等.微波组织凝固联合透热疗法治疗中心型肺癌对相关免疫指标的影响[J].第三军医大学学报,2016,21(3):200-202.doi:10.3321/j.issn:1000-5404.1999.03.015.
[11]朱风兰.经大肠镜高频电切大肠息肉213例分析[J].中华消化内镜杂志,2017,18(1):50.doi:10.3760/cma.j.issn.1007-5232.2017.01.025.
[12]白冲,李强,刘忠令,等.经纤支镜微波治疗在气道内疾病中的应用[J].中国内镜杂志,2016,8(1):7-9.doi:10.3969/j.issn.1007-1989.2002.01.003.
[13]Engelhardt R.Rational for clinical application of hyperther-mia and drugs[J].Strahlinther Onkol,2017,163:428-435.doi:10.1016/j.cct.2018.03.001.
[14]Tabuse KA.New operative of hepatic surgery using am-icrowavetissue coagulation[J].Arch Jpnchir,2016,48(6):60-67.doi:10.1080/13880209.2016.1577464.
[15]颜德中.经内镜不同电治疗方案对胃结肠息肉患者的临床疗效对比[J].中国医学前沿杂志(电子版),2015,6(8):98-100.doi:10.3969/j.issn.1674-7372.2014.08.041.
[16]刘宇虎,陈桂权,张志坚,等.经内镜微创电切治疗122例结直肠巨大息肉[J].广东医学,2016,33(22):3428-3430.doi:10.3969/j.issn.1001-9448.2012.22.028.
[17]张秀荣,李春启,李学甫,等.122例胃息肉的临床及病理分析与随访[J].中华消化内镜杂志,2016,15(4):42-43.doi:10.3760/cma.j.issn.1007-5232.1998.01.021.
[18]曹彬,陶锋,程雪霞,等.无痛内镜下高频电联合微波治疗胃十二指肠息肉的临床分析[J].现代消化及介入诊疗,2015,14(5):103-106.doi:10.3969/j.issn.1672-2159.2009.02.014.
[19]Rubio CA,Jaramillo E,Lindblom A,et al.Classification of colorectal polyps:guidelines for the eddoscopost[J].Endoscopy,2016,34(3):226-236.doi:10.1055/s-2002-20296.
[20]杨叶.糖尿病合并消化道息肉患者内镜下切除术的个体化治疗方案安全性分析[J].中国全科医学,2013,16(14):1667-1679.doi:10.3969/j.issn.1007-9572.2013.05.066.
[21]Park SY,Ryu JK,Park JH,et al.Prevalence of gastric and duodenal polyps and risk factors for duodenal neoplasm in korean pa-tients with familial adenomatous polyposis[J].Gut Liver,2016,15(5):46-56.doi:10.5009/gnl.2011.5.1.46.
[22]孙华波.内镜下微波灼除术和高频电切术治疗消化道息肉效果比较[J].山东医药2015,55(45):57-60.doi:10.3969/j.issn.1002-266X.2015.45.021.