老年人肠道较大隆起性病变的无痛内镜治疗体会

Experience in the treatment of painless endoscopy in elderly patients with large intestinal lesions

目的观察无痛内镜对老年人肠道较大隆起性病变的治疗方式及安全性。方法将33例肠道较大隆起性病变的老人随机分为黏膜切除术组(EMR组)和分次分片分时切除术组(EPMR组),观察两组术前、术中的血氧饱和度(Sp O2)、收缩压(SBP)、心率(HR)、呼吸(R)和疼痛感,以及两组手术时间(min)、出血量(m L)、住院时间(d)及并发症情况。结果 33例老年人的治愈率100%。EMR组在手术时间、出血量、住院时间均优于EPMR组,有显著性差异(P<0.05)。结论无痛内镜治疗老年人肠道隆起性病变,具有安全、有效、病人满意的优点,依病变的大小依次选择行EMR、EPMR治疗,特殊情况下主动放弃一次全部切除的计划,采取分时段再次手术治疗,能够达到预期的效果。

Objective To observe the efficacy and safety of painless endoscopy for elderly patients with large intestinal lesions. Methods A total of 33 elderly patients with large intestinal lesions were randomly divided into EMR group （23 cases） and EPMR group （ 10 cases）. The preoperative, intraoperative blood oxygen saturation （SpO2）, systolic blood pressure （SBP）, heart rate （HR）, respiration （R） and pain, as well as operation time （min）, bleeding volume （mL）, length of stay （d） and complications in the two groups were compared. Results Both the cure rate of the two groups were 100%. The operation time, bleeding volume and length of hospital stays of EMR group were less than that of EPMR group. There were significant differences （P 〈 0.05 ）. Conclusions Carrying out painless endoscopic treatment of intestinal lesions for elderly patients is safe, effective. The EMR or EPMR treatment could be chosen according to the size of the lesions. Under special circumstances, the plan of total removal of lesions could be replaced by the reoperation treatment during the divided period, which could achieve the expected effects.