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
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摘要
目的:分析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。方法:80例择期行手术治疗的消化道息肉患者随机分为研究组(n=40)和对照组(n=40)。研究组行内镜下橡皮圈套扎、对照组单纯行高频电切除术。术后2周复查内镜,了解两组手术效果,统计两组不同消化道病变部位息肉摘除成功率及手术并发症,并随访至少1年了解息肉复发或癌变情况。结果:研究组息肉摘除时间、创面愈合时间明显较对照组短,研究组息肉摘除成功率100.00%显著高于对照组87.50%,其中肠息肉摘除成功率、食管息肉摘除成功率均显著高于对照组,且无息肉残留,差异有统计学意义。研究组并发症发生率为15.00%显著低于对照组37.50%,且研究组并发两种及以上并发症发生率为5.00%显著低于对照组20.00%。两组随访期间均未见复发或癌变。结论:应用内镜下橡皮圈套扎治疗消化道息肉可在保障息肉摘除成功率的基础上,促进创面愈合,减少并发症,提高手术安全性。
Objective To analyze the clinical effects of endoscopic ligation with rubber band and high-frequency electroresection in the treatment of gastrointestinal polyps. Methods A total of 80 patients with gastrointestinal polyps were randomly divided into the study group(n=40) and the control group(n=40). The study group were treated with endoscopic ligation with rubberband and the control group were treated with high-frequency electroresection alone.2 weeks after surgery, endoscopy was performed to understand the surgical effects in the two groups. The success rate of polyp removal in different diseased regions and complications in the two groups were statistically analyzed, and all patients were followed up for at least 1 year to understand the status of recurrence or canceration. Results The duration of polyp removal and wound healing time was significantly shorter in the study group than the control group. The success rate of polyp removal was significantly higher in the study group than the control group(100.00% vs 87.50%), and the success rates of intestinal polyp removal and esophageal polyp removal were significantly higher in the study group than the control group, without polyp residue. The incidence of complications was significantly lower in the study groupthan the control group(15.00% vs 37.50%), and the incidence of more than two complications was significantly lower in the study group than the control group(5.00% vs 20.00%). There was no recurrence or canceration in the two groups. Conclusion The application of endoscopic ligation with rubber band and high-frequency electroresectioncan promote wound healing, reduce complications and improve surgical safety, on the basis of guaranteeing the success rate of polyp removal.
Objective To analyze the clinical effects of endoscopic ligation with rubber band and high-frequency electroresection in the treatment of gastrointestinal polyps. Methods A total of 80 patients with gastrointestinal polyps were randomly divided into the study group(n=40) and the control group(n=40). The study group were treated with endoscopic ligation with rubberband and the control group were treated with high-frequency electroresection alone.2 weeks after surgery, endoscopy was performed to understand the surgical effects in the two groups. The success rate of polyp removal in different diseased regions and complications in the two groups were statistically analyzed, and all patients were followed up for at least 1 year to understand the status of recurrence or canceration. Results The duration of polyp removal and wound healing time was significantly shorter in the study group than the control group. The success rate of polyp removal was significantly higher in the study group than the control group(100.00% vs 87.50%), and the success rates of intestinal polyp removal and esophageal polyp removal were significantly higher in the study group than the control group, without polyp residue. The incidence of complications was significantly lower in the study groupthan the control group(15.00% vs 37.50%), and the incidence of more than two complications was significantly lower in the study group than the control group(5.00% vs 20.00%). There was no recurrence or canceration in the two groups. Conclusion The application of endoscopic ligation with rubber band and high-frequency electroresectioncan promote wound healing, reduce complications and improve surgical safety, on the basis of guaranteeing the success rate of polyp removal.
引文
[1]李璧倩,张燕,陈元龙.3种内镜微创手术治疗消化道息肉的近远期疗效[J].解放军医药杂志,2016,28(10):77-80.
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[3]王一鸣,熊毅敏,郑国荣,等.钛夹及尼龙绳对预防大肠巨大有蒂息肉高频电凝切除术出血的临床研究[J].中国内镜杂志,2013,19(1):29-33.
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[5]何金财,吴联晖,宋鹏,等.内镜下橡皮圈联合尼龙绳结扎剥离术治疗胃固有肌层小肿瘤临床价值分析[J].中国内镜杂志,2015,21(2):181-185.
[6]Anderson ML,Pasha TM,Leighton JA.Endoscopic perforation of the colon:lessons from a 10-year study[J].Am J Gastroenterol,2000,95(12):3418-3422.
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[8]孙彩龙,周兰芳,金国文,等.急诊肠镜对结肠息肉电凝切除术后并发迟发性出血的诊疗价值[J].世界华人消化杂志,2013,21(16):1559-1562.
[9]Basford PJ,Longcroft-Wheaton G,Higgins B,et al.High-definition endoscopy with i-Scan for evaluation of small colon polyps:the Hi SCOPE study[J].Gastrointest Endosc,2014,79(1):111-118.
[10]黄永德,张志太,肖淑琼,等.经内镜尼龙绳套扎联合高频电切治疗结直肠巨大息肉的临床分析[J].临床军医杂志,2014,42(1):20-22+30.
[11]邓全军,谢立群,任万英,等.改良ESD联合橡皮圈套扎切除治疗胃固有肌层小肿瘤的临床研究[J].天津医药,2016,44(12):1480-1483.
[12]刘明成.内镜下橡皮圈套扎结合电凝电切治疗广基胃息肉50例分析[J].中国现代医药杂志,2012,14(1):90-91.
[13]许剑,尹灿,杨燕,等.内镜下尼龙绳结扎术在预防胃肠道宽基及粗蒂息肉电凝切术并发症的作用及意义[J].医学临床研究,2015,32(4):723-727.
[2]胥宾芬,范惠珍.内镜下微波灼除术与高频电切术治疗消化道息肉的效果比较[J].广东医学,2015,36(3):444-446.
[3]王一鸣,熊毅敏,郑国荣,等.钛夹及尼龙绳对预防大肠巨大有蒂息肉高频电凝切除术出血的临床研究[J].中国内镜杂志,2013,19(1):29-33.
[4]段志英,王鹏羽,韩双双,等.冷圈套治疗结直肠小息肉应用价值的Meta分析[J].中华消化内镜杂志,2015,32(12):832-836.
[5]何金财,吴联晖,宋鹏,等.内镜下橡皮圈联合尼龙绳结扎剥离术治疗胃固有肌层小肿瘤临床价值分析[J].中国内镜杂志,2015,21(2):181-185.
[6]Anderson ML,Pasha TM,Leighton JA.Endoscopic perforation of the colon:lessons from a 10-year study[J].Am J Gastroenterol,2000,95(12):3418-3422.
[7]刘伟,王水芳,牟一,等.内镜下冷圈套器治疗大肠息肉42例临床分析[J].中华消化内镜杂志,2014,31(9):519-521.
[8]孙彩龙,周兰芳,金国文,等.急诊肠镜对结肠息肉电凝切除术后并发迟发性出血的诊疗价值[J].世界华人消化杂志,2013,21(16):1559-1562.
[9]Basford PJ,Longcroft-Wheaton G,Higgins B,et al.High-definition endoscopy with i-Scan for evaluation of small colon polyps:the Hi SCOPE study[J].Gastrointest Endosc,2014,79(1):111-118.
[10]黄永德,张志太,肖淑琼,等.经内镜尼龙绳套扎联合高频电切治疗结直肠巨大息肉的临床分析[J].临床军医杂志,2014,42(1):20-22+30.
[11]邓全军,谢立群,任万英,等.改良ESD联合橡皮圈套扎切除治疗胃固有肌层小肿瘤的临床研究[J].天津医药,2016,44(12):1480-1483.
[12]刘明成.内镜下橡皮圈套扎结合电凝电切治疗广基胃息肉50例分析[J].中国现代医药杂志,2012,14(1):90-91.
[13]许剑,尹灿,杨燕,等.内镜下尼龙绳结扎术在预防胃肠道宽基及粗蒂息肉电凝切术并发症的作用及意义[J].医学临床研究,2015,32(4):723-727.