内镜下黏膜切除术与高频电凝套扎术治疗胃肠道息肉的疗效及安全性

Evaluation on the safety and effect of endoscopic mucosal resection and high frequency electrocoagulation in gastrointestinal polyps

目的:比较内镜下黏膜切除术(EMR)与高频电凝套扎术治疗胃肠道息肉的疗效和安全性。方法:将我院2015年1月~2017年10月收治的胃肠道息肉患者112例随机分为单纯圈套组(49例,行高频电凝切除术)和EMR组(63例,行内镜下黏膜切除术);比较两种术式的完整切除率、手术平均时间、术中出血率、术后出血率、术后穿孔率等指标。结果:治疗山田Ⅰ~Ⅱ型息肉,单纯圈套组完整切除率(70.83%)低于EMR组(96.77%)(P<0.05);但治疗山田Ⅲ~Ⅳ型息肉,两组的完整切除率差异无统计学意义(P>0.05)。单纯圈套组术中出血率(22.45%)高于EMR组(6.35%)(P<0.05)。两组的平均手术时间、术后出血率和术后穿孔率等指标差异无统计学意义(P>0.05)。结论:治疗山田Ⅰ~Ⅱ型息肉,内镜下黏膜切除术的疗效和安全性优于高频电凝套扎术。

Objective：To compare the efficacy and safety of endoscopic mueosal resection （EMR） and high frequency eleetroeoagulation in the treatment of gastrointestinal polyps. Methods：A total of 112 patients with gastrointestinal polyps admitted to and treated in our department between January 2015 and October 2017 were randomized into high frequency eleetroeoagulation group （n=49） and EMR group （n= 63）. Then the two groups were compared con- ceming the complete resection rate, mean operative time,intraoperative and postoperative bleeding rate, and perforation rate following operation. Results： The complete resection rate was significantly lower in high frequency eleetroeoagulation group （70.83%） than that in EMR group （96.77%） in treating Y amada Ⅰ -Ⅱ type polyps （ P〈 0.05 ）, yet the diffrence was insignificant for Yamada Ⅲ- Ⅳ type polyps （ P〉 0.05 ）. High frequency eleetroeoagulation re- sulted in higher intraoperative bleeding rate than EMR（22.45% vs. 6.35%） （P〈0.05）, yet the difference was not significant between groups regarding mean operative time and incidences of postoperative bleeding and perforation（P〉0.05）. Conclusion：EMR can be safer and more effective than high fre- quency eleetroeoagulation in the treatment of Yamada Ⅰ-Ⅱ type polyps.