内镜下注水法冷圈套器切除术在治疗5~10 mm无蒂型大肠息肉中的疗效分析

doi:10.3969/j.issn.1000-8535.2024.03.014

广州医药 ›› 2024, Vol. 55 ›› Issue (3): 300-305.DOI: 10.3969/j.issn.1000-8535.2024.03.014

内镜下注水法冷圈套器切除术在治疗5~10 mm无蒂型大肠息肉中的疗效分析

张宗胜¹, 陈明仁¹, 刘浪廷¹, 李卫娜¹, 韩燕燕¹, 卢敏²

1 阳春市中医院消化内科（广东阳春 529600）;
2 南方医科大学珠江医院消化内科（广东广州 510280)

收稿日期:2023-11-09 出版日期:2024-03-20 发布日期:2024-04-12
通讯作者: 卢敏,E-mail:lumin2009amy@163.com
基金资助:
阳江市科技局医疗卫生科技项目（SF2021173）

Analysis of the therapeutic effect of endoscopic underwater cold snare polypectomy in the treatment of 5-10 mm sessile colorectal polyps

ZHANG Zongsheng¹, CHEN Mingren¹, LIU Langting¹, LI Weina¹, HAN Yanyan¹, LU Min²

1 Department of Gastroenterology,Yangchun Traditional Chinese Medicine Hospital,Yangchun 529600,China;
2 Department of Gastroenterology,Southern Medical University Zhujiang Hospital,Guangzhou 510280,China

Received:2023-11-09 Online:2024-03-20 Published:2024-04-12

摘要/Abstract

摘要： 目的研究注水法内镜下冷圈套器切除术在5~10 mm 无蒂型大肠息肉中的临床疗效。方法纳入120例阳春市中医院收治的5~10 mm 无蒂型大肠息肉患者,合计246枚息肉,根据结肠息肉切除方式不同分为内镜下注水法冷圈套器切除术（UCSP）与传统内镜下冷圈套器切除术（CCSP）两组,每组分别纳入60例患者。比较两组息肉部位、息肉大小、术后病理诊断、完整息肉切除率、术后病理深度、息肉回收率、手术时间、术中瞬时性出血率、迟发性穿孔率、迟发性出血率以及手术时间、Boston及视觉模拟评分法（VAS）评分。结果两组息肉部位、息肉大小、术后病理诊断、完整息肉切除率、息肉回收率、术中瞬时性出血率、迟发性穿孔率、迟发性出血率以及Boston评分比较差异均无统计学意义（P>0.05）;UCSP组术后病理深度[（8.80.5）mm]大于CCSP组[（5.90.4）mm]（P<0.01）,CCSP 组手术时间[（21.32.4）min],较UCSP组[（25.71.1）min]缩短（P<0.01）,VAS评分UCSP组[（2.60.7）分]优于CCSP组[（2.90.3）分]（P<0.001）。结论 UCSP能有效、安全5~10 mm无蒂型大肠息肉,术后深度的病理组织学评估获得更高的肌层黏膜切除深度,虽然UCSP手术时间较长,但术后腹痛发生率较低。

关键词: 注水冷圈套器切除术, 冷圈套息肉切除术, 大肠息肉, 瞬时性出血, 腹痛

Abstract: Objective To study the clinical efficacy of endoscopic cold snare resection using water injection method in 5-10 mm pedunculated colorectal polyps. Methods A total of 120 patients with 5-10 mm sessile colorectal polyps admitted to Yangchun Traditional Chinese Medicine Hospital were selected as the research subjects．A total of 246 polyps were enrolled,and the patients were divided into two groups based on the different methods of endoscopic resection：underwater cold snare polypectomy（UCSP）and conventional cold snare polypectomy（CCSP）,with 60 patients enrolled in each group．Compare the location,size,postoperative pathological diagnosis,complete polypectomy rate,postoperative pathological depth,polyp recovery rate,surgical time,instantaneous intraoperative bleeding rate,delayed perforation rate,delayed bleeding rate,surgical time,Boston and VAS scores between two groups. Results Two groups of polyp locations,polyp size,postoperative pathological diagnosis,complete polyp resection rate,polyp recovery rate,the instantaneous intraoperative bleeding rate,delayed perforation rate,delayed bleeding rate,and Boston score,all of above were not significant different（P>0.05）;the postoperative pathological depth in the UCSP group[（8.8±0.5）mm] was significantly greater than that in the CCSP group[（5.9±0.4）mm]（P<0.01）,and the surgical time in the CCSP group[（21.3±2.4）min] was shorter than that in the UCSP group[（25.7±1.1）min]（P<0.01）． The VAS score in the UCSP group（2.6±0.7）was significantly better than that in the CCSP group（2.9±0.3）（P<0.001）. Conclusions The underwater cold snare polypectomy can achieve good therapeutic results in patients with 5-10 mm sessile colorectal polyps．Further pathological evaluation of postoperative can obtain deeper of myomucosal resection．Although the UCSP group has a longer surgical time,the incidence of postoperative abdominal pain is lower．

Key words: underwater cold snare polypectomy, cold snare polypectomy, colorectal polyps, instantaneous bleeding, abdominal pain

张宗胜, 陈明仁, 刘浪廷, 李卫娜, 韩燕燕, 卢敏. 内镜下注水法冷圈套器切除术在治疗5~10 mm无蒂型大肠息肉中的疗效分析[J]. 广州医药, 2024, 55(3): 300-305.

ZHANG Zongsheng, CHEN Mingren, LIU Langting, LI Weina, HAN Yanyan, LU Min. Analysis of the therapeutic effect of endoscopic underwater cold snare polypectomy in the treatment of 5-10 mm sessile colorectal polyps[J]. Guangzhou Medical Journal, 2024, 55(3): 300-305.

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内镜下注水法冷圈套器切除术在治疗5~10 mm无蒂型大肠息肉中的疗效分析

Analysis of the therapeutic effect of endoscopic underwater cold snare polypectomy in the treatment of 5-10 mm sessile colorectal polyps

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