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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

来源期刊: 广州医药 | 300-305 发布时间:2024-04-12 收稿时间:2025/11/13 18:50:19 阅读量:21
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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
underwater cold snare polypectomycold snare polypectomycolorectal polypsinstantaneous bleedingabdominal pain
DOI:
10.3969/j.issn.1000-8535.2024.03.014
收稿时间:
2023-11-09 
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引用总数:
1  
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。
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.
1、 令狐恩强. 内镜下黏膜切除术后病变的残留与对策[J].中华消化内镜杂志,2011,28(2):61-62. 令狐恩强. 内镜下黏膜切除术后病变的残留与对策[J].中华消化内镜杂志,2011,28(2):61-62.
2、 ZHANG Q,GAO P,HAN B,et al.Polypectomy for complete endoscopic resection of small colorectal polyps[J].Gastrointest Endosc,2018,87(3):733-740. ZHANG Q,GAO P,HAN B,et al.Polypectomy for complete endoscopic resection of small colorectal polyps[J].Gastrointest Endosc,2018,87(3):733-740.
3、 何飞云,叶斌,刘双亮,等.注水辅助结肠镜检查的应用价值研究[J].浙江医学,2019,41(10):1057-1058,1064. 何飞云,叶斌,刘双亮,等.注水辅助结肠镜检查的应用价值研究[J].浙江医学,2019,41(10):1057-1058,1064.
4、 马师洋,张莉,宋亚华,等.比较注水肠镜与传统注气肠镜检查对老年患者结肠息肉检出率的影响[J].胃肠病学和肝病学杂志,2017,26(2):188-190. 马师洋,张莉,宋亚华,等.比较注水肠镜与传统注气肠镜检查对老年患者结肠息肉检出率的影响[J].胃肠病学和肝病学杂志,2017,26(2):188-190.
5、 CAMMAROTA G,CESARO P,CAZZATO A,et al.The water immersion technique is easy to learn for routine use during EGD for duodenal villous evaluation:A single-center 2-year experience[J].J Clin Gastroenterol,2009,43(3):244-248. CAMMAROTA G,CESARO P,CAZZATO A,et al.The water immersion technique is easy to learn for routine use during EGD for duodenal villous evaluation:A single-center 2-year experience[J].J Clin Gastroenterol,2009,43(3):244-248.
6、 BINMOELLER K F,WEILERT F,SHAH J,et al.“Underwater” EMR without submucosal injection for large sessile colorectal polyps(with video)[J].Gastrointest Endosc,2012,75(5):1086-1091. BINMOELLER K F,WEILERT F,SHAH J,et al.“Underwater” EMR without submucosal injection for large sessile colorectal polyps(with video)[J].Gastrointest Endosc,2012,75(5):1086-1091.
7、 张少锋,向治纬.175例结肠镜诊断和治疗结肠息肉的临床分析[J].中国内镜杂志,2017,23(2):42-48. 张少锋,向治纬.175例结肠镜诊断和治疗结肠息肉的临床分析[J].中国内镜杂志,2017,23(2):42-48.
8、 KIM G U,SEO M,SONG E M,et al.Association between the ulcer status and the risk of delayed bleeding after the endoscopic mucosal resection of colon[J].Endosc Int Open,2017,32(11):1846-1851. KIM G U,SEO M,SONG E M,et al.Association between the ulcer status and the risk of delayed bleeding after the endoscopic mucosal resection of colon[J].Endosc Int Open,2017,32(11):1846-1851.
9、 李国栋,金娟,何承海,等.内镜下冷圈套切除术与黏膜切除术治疗结直肠亚蒂型息肉的疗效对比[J].浙江医学,2022,44(20):2189-2193,封3. 李国栋,金娟,何承海,等.内镜下冷圈套切除术与黏膜切除术治疗结直肠亚蒂型息肉的疗效对比[J].浙江医学,2022,44(20):2189-2193,封3.
10、 李杨,汪胡根,蔡轶,等.结肠息肉圈套器冷切除术后瞬时性出血风险因素分析[J].安徽医药,2021,25(8):1505-1508. 李杨,汪胡根,蔡轶,等.结肠息肉圈套器冷切除术后瞬时性出血风险因素分析[J].安徽医药,2021,25(8):1505-1508.
11、 ABE Y,NABETA H,KOYANAGI R,et al.Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate[J].Endosc Int Open,2018,6(2):E254-E258. ABE Y,NABETA H,KOYANAGI R,et al.Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate[J].Endosc Int Open,2018,6(2):E254-E258.
12、 IKEDA T,YOSHIZAKI T,EGUCHI T,et al.Efficacy of specimen pasting after cold snare polypectomy for pathological evaluation of horizontal margins[J].Endosc Int Open,2022,10(5):E572-E579. IKEDA T,YOSHIZAKI T,EGUCHI T,et al.Efficacy of specimen pasting after cold snare polypectomy for pathological evaluation of horizontal margins[J].Endosc Int Open,2022,10(5):E572-E579.
13、 ISHIBASHI F,SUZUKI S,NAGAI M,et al.Colorectal cold snare polypectomy:Current standard technique and future perspectives[J].Dig Endosc,2023,35(3):278-286. ISHIBASHI F,SUZUKI S,NAGAI M,et al.Colorectal cold snare polypectomy:Current standard technique and future perspectives[J].Dig Endosc,2023,35(3):278-286.
14、 中国医师协会内镜医师分会消化内镜专业委员会,中国抗癌协会肿瘤内镜学专业委员会.中国消化内镜诊疗相关肠道准备指南(2019,上海)[J].中华消化内镜杂志,2019,36(7):457-469. 中国医师协会内镜医师分会消化内镜专业委员会,中国抗癌协会肿瘤内镜学专业委员会.中国消化内镜诊疗相关肠道准备指南(2019,上海)[J].中华消化内镜杂志,2019,36(7):457-469.
15、 温必盛,杨维忠,崔光锐,等.注水结肠镜下黏膜切除术治疗结直肠无蒂大息肉的临床应用[J].现代消化及介入诊疗,2018,23(4):438-440. 温必盛,杨维忠,崔光锐,等.注水结肠镜下黏膜切除术治疗结直肠无蒂大息肉的临床应用[J].现代消化及介入诊疗,2018,23(4):438-440.
16、 张娟丽,聂璐,苏成霞,等.冷圈套息肉切除术对直径≤15 mm结肠息肉内镜下切除及减轻机体应激和炎性反应的研究[J].中华实验外科杂志,2023,40(7):1394-1396. 张娟丽,聂璐,苏成霞,等.冷圈套息肉切除术对直径≤15 mm结肠息肉内镜下切除及减轻机体应激和炎性反应的研究[J].中华实验外科杂志,2023,40(7):1394-1396.
17、 葛军,赵冰,杨熹,等.结肠息肉内镜下切除术后迟发性出血止血效果及危险因素分析[J].江苏大学学报(医学版),2022,32(3):262-265. 葛军,赵冰,杨熹,等.结肠息肉内镜下切除术后迟发性出血止血效果及危险因素分析[J].江苏大学学报(医学版),2022,32(3):262-265.
18、 林丽琳,陈素玉,陈建华,等.冷圈套器切除术治疗右半结肠浅表型息肉的安全性分析[J].中国内镜杂志,2023,29(4):64-72. 林丽琳,陈素玉,陈建华,等.冷圈套器切除术治疗右半结肠浅表型息肉的安全性分析[J].中国内镜杂志,2023,29(4):64-72.
19、 KARSTENSEN J G,EBIGBO A,DESALEGN H,et al.Colorectal polypectomy and endoscopic mucosal resection:European Society of Gastrointestinal Endoscopy Cascade Guideline[J].Endosc Int Open,2022,10(11):E1427-E1433. KARSTENSEN J G,EBIGBO A,DESALEGN H,et al.Colorectal polypectomy and endoscopic mucosal resection:European Society of Gastrointestinal Endoscopy Cascade Guideline[J].Endosc Int Open,2022,10(11):E1427-E1433.
20、 MARUOKA D,ARAI M,AKIZUE N,et al.Residual adenoma after cold snare polypectomy for small colorectal adenomas:A prospective clinical study[J].Endoscopy,2018,50(7):693-700. MARUOKA D,ARAI M,AKIZUE N,et al.Residual adenoma after cold snare polypectomy for small colorectal adenomas:A prospective clinical study[J].Endoscopy,2018,50(7):693-700.
21、 骆震,孙常波,李江波,等.内镜下结肠息肉冷切除术治疗微小结肠息肉的效果观察[J].现代实用医学,2022,34(4):519-520. 骆震,孙常波,李江波,等.内镜下结肠息肉冷切除术治疗微小结肠息肉的效果观察[J].现代实用医学,2022,34(4):519-520.
22、 中华医学会消化内镜学分会.中国结直肠息肉冷切专家共识(2023年,杭州)[J].中华胃肠内镜电子杂志,2023,10(2):73-82. 中华医学会消化内镜学分会.中国结直肠息肉冷切专家共识(2023年,杭州)[J].中华胃肠内镜电子杂志,2023,10(2):73-82.
23、 陆宝钿,李兆滔,崔西玉,等.佛山地区大肠锯齿状腺瘤的发病情况及临床特点[J].广州医药,2019,50(6):78-82,101. 陆宝钿,李兆滔,崔西玉,等.佛山地区大肠锯齿状腺瘤的发病情况及临床特点[J].广州医药,2019,50(6):78-82,101.
24、 徐科,周良,马春淼,等.儿童结直肠息肉98例的临床特征及腹腔镜联合结肠镜下手术治疗效果[J].广州医药,2023,54(10):63-67,105. 徐科,周良,马春淼,等.儿童结直肠息肉98例的临床特征及腹腔镜联合结肠镜下手术治疗效果[J].广州医药,2023,54(10):63-67,105.
25、 胡娜,叶长根,冷芳.结肠息肉的病理特点与年龄、性别关系研究分析[J].江西医药,2021,56(12):2216-2218. 胡娜,叶长根,冷芳.结肠息肉的病理特点与年龄、性别关系研究分析[J].江西医药,2021,56(12):2216-2218.
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