610例结肠息肉内镜治疗分析

Analysis of 610 cases with colonic polyps by therapeutic endoscopy

目的对内镜下结肠息肉切除的疗效、安全性进行评价。方法针对息肉的部位、大小、形态以及组织学不同,采取恰当的息肉切除方法。结果结肠息肉610例,均全部切除。镜下分类:有蒂134例(21.97%)、无蒂356例(58.36%)、广基70例(11.47%)、扁平状50例(8.20%);组织学分类:腺瘤性息肉385例(63.11%)、炎症性息肉132例(21.64%)、错构瘤型息肉46例(7.54%)、增生性息肉47例(7.71%)。术后出血15例,均为广基和扁平状息肉。8例患者出血自行停止,7例需内镜下止血。2例发生穿孔,也发生广基和扁平状息肉患者,需行手术治疗。结论做好充分的术前准备、恰当选择切除方法,对保证切除成功及预防出血、穿孔、烧伤等并发症有重要意义。

Objective To evaluate the effect and security of therapeutic endoscopy in colonic polyps. Methods To perfrom the correct polypectomy according to the various site,size,morphous and histology. Results Among the 610 cases by polypectomy,in classification of endoscopy,there were 134 cases with pedunculated polyps,356 cases with nonpeduncle polyps, 70 cases with lati- base polyps and 50 cases with applanation polyps. However, in histology, 385 cases with adenomatous polyps, 132 cases with inflam- matory polyps,46 cases with hamartomatous polyps and 47cases with hyperplastic polyp. It happened postoperative hemorrhage in 15 cases with latibase and applanation polyps. Among them, 8 cases could be hemostasis by itself, while 7 cases could be hemostasis by endoscopy. Two cases with latibase and applanation polyps were operated owning to perforation. Conclusion Sufficient preoperotive preparation and appropriate polypectomy have important significance for ensuring successful treatment and prophylaxis of hemorrhage, perforation and burns.