结肠镜联合腹腔镜治疗结肠息肉的疗效观察

Observation of the curative effect of colonoscopy combined with laparoscope in the treatment of colonic polyps

目的：探讨结肠镜、腹腔镜双镜联合治疗结肠息肉的疗效。方法回顾性分析结肠息肉患者48例的临床资料，依据患者手术方式分为观察组23例、对照组25例；观察组采用结肠镜、腹腔镜双镜联合对结肠息肉行根治手术，对照组采用传统开腹手术切除息肉。观察两组手术时间、术中出血量、排气及排便时间、住院天数及费用以及术后并发症。结果两组均顺利完成手术，观察组术手术时间、术中出血量分别为（78．3±8．2）min、（13．1±4．5）mL，对照组分别为（115．5±10．1）min、（63．6±18．1）mL，两组差异均有统计学意义（t ＝13．93、13．01，均 P ＜0．05）。观察组肛门排气时间、排便时间分别为（25．1±6．5）h、（42．5±7．6）h，均明显短于对照组的（36．6±8．1）h、（82．3±11．5）h，差异均有统计学意义（t ＝5．39、14．01，均 P ＜0．05）。观察组住院时间、住院费用分别为（5．5±0．6）d、（13842．5±875．5）元，对照组分别为（8．2±1．5）d、（18992．5±1001．5）元，两组差异均有统计学意义（t ＝8．05、18．89，均 P ＜0．05）。观察组术后发生肺部感染1例、吻合口瘘2例、肠梗阻1例，对照组术后发生肺部感染2例、肠梗阻2例，两组术后并发症发生情况差异无统计学意义（P ＞0．05）。结论对于单纯结肠镜治疗困难的结肠息肉，结肠镜、腹腔镜双镜联合治疗既可以保持微创性又可以提高安全性，严格把握手术指征，更能发挥双镜联合的优势。

Objective To explore the curative effect of colonoscopy combined with laparoscope in the treatment of colonic polyps.Methods The clinical data of 48 cases with colonic polyps were retrospectively analyzed.According to the operation pattern,the patients were divided into observation group（23 cases）and control group（25 cases）.The observation group received colonoscopy combined with laparoscopy for radical surgery of colon polyps,the control group used the traditional open surgery to remove polyps.The operation time,bleeding volume, exhaust and defecation time,hospital days and cost as well as postoperative complications were observed.Results The two groups were successfully completed surgery.The operative time,bleeding volume of the observation group were （78.3 ±8.2）min and （1 3.1 ±4.5）mL respectively,which of the control group were （1 1 5.5 ±1 0.1 ）min, （63.6 ±1 8.1 ）mL,the differences between the two groups were statistically significant（t =1 3.93,1 3.01 ,all P 〈0.05）.The anal exhaust time and defecation time of the observation group were （25.1 ±6.5）h and （42.5 ±7.6）h, which were significantly shorter than those of the control group[（36.6 ±8.1 ）h,（82.3 ±1 1 .5）h],the differences were statistically significant（t =5.39,1 4.01 ,all P 〈0.05）.The hospitalization time,hospital costs of the observation group were （5.5 ±0.6）d,（1 3 842.5 ±875.5）yuan,which of the control group were （8.2 ±1 .5）d,（1 8 992.5 ± 1 001 .5）yuan,the differences between the two groups were statistically significant（t =8.05,1 8.89,all P 〈0.05）. Pulmonary infection in 1 case,anastomotic fistula in 2 cases,1 case of intestinal obstruction in the observation group, and in the control group,pulmonary infection occurred in 2 cases,2 cases of intestinal obstruction,the postoperative complications between the two groups had no statistically significant difference（P 〉0.05）.Conclusion For simple colonoscopy treatment difficulties of colon polyps,colonoscopy,laparoscopy combined treatment is minimally invasive and can improve the safety,strictly control surgical indications,can give full play to the double mirror combined advantage.