钛夹预防性蒂部结扎在内镜下切除大肠带蒂息肉的应用

Application of prophylactic peduncle ligature with titanium clips in the endoscopic resection of pedunculated colorectal polyps

目的观察在内镜下切除大肠带蒂息肉时先用钛夹结扎息肉蒂部的预防出血作用。方法采用随机分组方法,将50例大肠带蒂息肉患者分为对照组(n=25)和治疗组(n=25)。对照组直接用圈套器套扎息肉行电凝电切;治疗组先用金属钛夹完整钳夹息肉蒂部,再在钛夹上方圈套息肉行电凝电切。结果两组50例大肠息肉均顺利切除,对照组有6例术中发生蒂部切口出血,用钛夹钳夹残蒂后血止,术中出血发生率为24.0%;而治疗组无一例发生术中出血。所有患者随访2个月均未发生术后出血,亦未见穿孔和其他严重并发症。结论对带蒂大肠息肉采取钛夹结扎息肉蒂部后再行电凝电切能有效地预防术中出血。

Objective To observe the bleeding prevention of prophylactic peduncle ligature with titanium clips in the endoscopic treatment of pedunculated colorectal polyps. Methods Fifty cases of pedunculated colorectal polyps were randomly divided to control group （n = 25） and treatment group （n = 25）. The polyps of control group were removed by endoscopic high-frequency therapy with snare simply. The polyps of treatment group were ligatured around peduncle with titanium clips before endoscopic high-frequency therapy. Results All polyps were removed successfully. 6 cases of control group （6/25, 24.0%） occured bleeding, which were stopped by titanium clips. No bleeding was observed in treatment group. After 2 months followed up, all the cases were no rebleeding, perforation and other complications. Conclusion Prophylactic peduncle ligature with titanium clips can prevent bleeding effectively in the endoscopic re- section of pedunculated coloreetal polyps.