应用结肠镜反转接触式氩离子凝固术治疗超低位直肠息肉的疗效分析

Curative Effect Analysis of Retroflex Colonoscopy Contact-Mode APC in the Treatment of Ultra-Low Rectal Polyp

目的探讨应用结肠镜反转接触式氩离子凝固术(APC)治疗超低位直肠息肉的疗效。方法选取2015年4月至2017年4月在我院治疗的超低直肠息肉患者80例,根据治疗方式分为观察组(n=49)和对照组(n=31),观察组给予肠镜反转接触式APC治疗,对照组给予常规非接触式APC治疗,观察两组治疗效果、APC喷凝次数、手术时间、术中出血量等。结果观察组和对照组息肉均经1次肠镜APC治疗后成功灼除;观察组和对照组息肉复发率分别为2.04%和6.45%,差异比较无统计学意义(P>0.05);观察组APC喷凝次数和术中出血量分别为(3.51±0.66)次和(34.12±6.11)m L,明显少于对照组,差异有统计学意义(P<0.05);观察组和对照组手术时间比较差异无统计学意义(P>0.05);观察组肠功能恢复时间、住院时间和肠镜镜身受损率分别为(15.21±2.13)h、(5.21±1.17)d和0.00%,明显低于对照组,差异有统计学意义(P<0.05)。观察组和对照组未发现有严重并发症发生。结论应用结肠镜反转接触式APC治疗超低位直肠息肉是一种安全有效的方法,能降低肠镜镜身的损伤率。

Objective To discuss the curative effect of retroflex colonoscopy contact-mode argon plasma coagulation（APC）in the treatment of ultra-low rectal polyp. Methods Collect 80 patients with ultra-low rectal polyp undergoing treatment in the hospital from April 2015 to April 2017,and divide them into observation group（ n =49）and control group（ n =31）by treatment patterns.The observation group was treated by retroflex colonoscopy contact-mode APC,while the control group was treated by conventional non-contacting APC,and observe treatment effect,APC spraying coagulation times,operation time,intraoperative blood loss and so on between the two groups. Results The polyps in both the observation group and control group were successfully removed after 1 colonoscopic APC treatment; the polyp recurrence rate in the observation group and control group were 2.04% and 6.45%,and the difference was not statistically significant（ P 〉0.05）; in the observation group,the number of APC spraying times and intraoperative blood loss were（3.51±0.66）and（34.12±6.11）mL,significantly less than the control group,with statistically significant difference（ P 〈0.05）;there was no statistically significant difference in operation time between the observation group and the control group（ P 〉0.05）; in the observation group,intestinal function recovery time,hospitalization time,and the damage rate of the colonoscopy were（15.21±2.13）h,（5.21±1.17）d and 0,significantly lower than the control group,and the difference was statistically significant（ P 〈0.05）.No serious complication was observed in the observation group and control group. Conclusion It is a safe and effective method to treat ultra-low rectal polyp with retroflex colonoscopy contact-mode APC,which can reduce the injury rate of the colonoscopy.