内镜下黏膜下切除与电凝切除治疗扁平型病灶的比较

Compare the effect of EMR and coagulation in endoscopical treatment of flat lesions

目的比较内镜下黏膜下切除与电凝切除胃肠扁平病灶的临床效果。方法将90例胃肠扁平病灶按≤1cm和>1cm随机均分为2组,分别行黏膜下切除和电凝切除的治疗方法,统计出血、穿孔等并发症和复发率。结果对≤1cm的胃肠扁平病灶,黏膜下切除组和电凝切除组的并发症发生率分别为3.8%和0,P>0.05,统计学差异无显著性;复发率分别为0和11.5%,P<0.05,差异具有显著性。对>1cm的胃肠扁平病灶,黏膜下切除组和电凝切除组的并发症发生率分别为15.8%和0,P<0.05,有显著统计学差异;复发率分别为10.5%和26.3%,P<0.05,差异有显著性。结论内镜下黏膜下切除能较好地根除胃肠扁平病灶,复发率低,但并发症发生率相对较高;电凝切除治疗胃肠扁平病灶并发症发生率低,相对安全,但复发率较高。

[Objective] Compare the clinical effect of EMR and coagulation ifi endoscopical treatment of the fiat lesions. [Methods] Assigned 90 gastrointestinal flat in 2 groups according to its size of 〈1 cm and 〉1 cm meanly, treated them with EMR and coagulation, then analyzed the complication and recurrence rate as bleeding and perforation. [Result] ≤ 1 cm fiat lesions, the complication rate of EMR group and coagulation group are 3.8% and 0 respectively, P 〉0.05, and no significant difference; the recurrence rate of the two groups are 0 and 11.5%, P 〈0.05, and with significant difference. In 〉1 cm flat lesions, the complication rate of EMR and coagulation group are 15.8% and 0, P 〈0.05, with significant difference; the recurrence rate of the A and B groups are 10.5% and 26.3%, P 〈 0.05, and with significant difference. [Conclusions] EMR can remove the fiat lesions clearly with lower recurrence rate while higher complication rate; coagulation is more safe with lower complication rate, but sometime there will be higher recurrence.