大、小肠息肉及肿物的腔内治疗（附6091枚息肉分析）

Endoscopic Management of Intestinal Polyps.An Analysis of 6091 Polyps Removed

近１０年来应用纤维结肠镜检查了有腹痛、腹泻或便血等患者１１０４２例，检出大、小肠息肉２６１４例（２３．６７％）。摘除０．３～１０ｃｍ息肉６０９１枚，其中镜从小肠中段切口或从肛门插入清除小肠息肉９例，息肉６２枚。无肠穿孔、大出血等严重并发症。在摘除巨大息肉时，每圈套一块组织应＜２．０ｃｍ。对全身情况好的中青年患者，如息肉有蒂，可适当增加摘除息肉的枚数。本组１次圈套摘除１．０～２．５ｃｍ的有蒂息肉１０枚以上者８１例次，其中１次摘除最多者４６枚，最大１枚１０ｃｍ×９ｃｍ×８ｃｍ。１次凝除小息肉最多的是７０枚。

Among 11042 patients with symptoms of abdominal pain, diarrhea or bloody stool,2614 (23.67%) cases of bowel polyps were identified with colonoscopy over the past 10 years.6091 bowel polyps with the diameter between 0.3cm to 10cm from 2614 patients were diagnosed and extirpated under colonoscopy.Among them, 62 small intestinal polyps in 9 patients were removed at laparotomy via colonoscope introduced via small bowel incision.No serious complications (perforation or massive bleeding) occurred during the procedures.The magnitude of the tissue snared off should be smaller than 2.0cm in diameter in dealing with giant polyps.More polyps were extirpated during one episode of operation if the patient was young and was not complicated with other diseases, or ifthe polyps were pedunculated.Snare polypectomy of more than 10 polyps of 1.02.5cm at one session were performed in 81 patients.The maximum number of polyps resected at one time was 46 by snare and 70 with electrocoagulation.The largest resected polyp was 10cm×9cm×8cm in size.