冷圈套与热圈套切除结直肠小息肉的病例对照研究

A comparative study of cold snare and hot snare resection of small colorectal polyps

目的 比较冷圈套与热圈套对于结直肠小息肉的切除效果,探讨冷圈套技术切除结直肠小息肉的临床应用价值.方法 以2017年9月1日至2018年1月31日于北京大学国际医院消化内科行结直肠息肉切除的206例患者为研究对象,包括冷圈套组103例（158枚）,以随机选取的同期热圈套患者103例（180枚）作为对照组.对相关临床资料进行回顾性分析,比较两组息肉的部位、形状、大小、切除时间、病理类型、完整切除率、标本回收率、并发症、相关费用等.结果 冷圈套组息肉切除时间短于热圈套组,差异有统计学意义（Z=-11.727,P〈0.001）;冷圈套组围手术期相关费用低于热圈套组,差异有统计学意义（Z=-12.680,P〈0.001）.两组患者息肉数量/例、部位、息肉大小、形态、病理分型、完整切除率、标本回收率、围手术期并发症,差异无统计学意义（P〉0.05）.结论冷圈套技术切除结直肠息肉（直径6～9 mm）操作时间短、费用低,值得临床推广.

Objective To compare the effect of cold snare and hot snare on the resection of small colorectal polyps, and to explore the clinical value of cold snare technique in removing colorectal polyps . Methods From September 1,2017 to January 31,2018,206 cases of patients with colorectal polyp resection in the Department of Gastroenterology of Peking University International Hospital were studied .During this period, according to the standard, 103 cases of patients （158 polyps） were in the cold snare group, and 103 patients （180 polyps） were randomly selected as control group from patients of the hot snare group .The related clinical data were analyzed retrospectively . The location, shape, size, polypectomy time, pathological type, complete resection rate, specimen recovery rate, complications and related costs of the two groups of polyps were compared.Results The polypectomy time of the cold snare group was shorter than that of the hot snare group.The difference was statistically significant （ Z =-11.727,P 〈0.001） .The related cost of the perioperative period of the cold snare group was lower than that of the hot snare group .The difference was statistically significant （ Z =-12.680,P 〈0.001） .There were no statistically significant differences in the number of polyps /case, size, shape, pathological classification, complete resection rate, specimen recovery rate, and perioperative complications of the patients in the two groups （ P 〉0.05） . Conclusions The operation time of cold snare technique in colorectal polyps （6 -9 mm in diameter） is shorter and the cost is lower, which is worthy of clinical promotion.