大肠息肉治疗注水法内镜下黏膜切除术与高频电切术效果的随机对照研究

Comparative Study of the Treatment of Large Intestine Polyps by Underwater Endoscopic Mucosal Resection and High Frequency Electric Resection

目的探讨注水法内镜下黏膜切除术(UEMR)治疗与高频电切术治疗在大肠息肉临床治疗中的临床疗效及安全性对比。方法 2016年1月至2017年7月肠镜检出患有大肠息肉疾病的患者200例,随机分为注水法内镜下黏膜切除术(UEMR)治疗(A组)与高频电切术治疗(B组)两组,每组100例。对比患者耐受性、疗效及术中、术后并发症情况。结果①组间一般临床资料差异无统计学意义(P> 0.05);②2组间Boston评分、插管成功率等差异无统计学意义(P> 0.05);③A组:注水法内镜下黏膜切除术(UEMR)组患者息肉一次性切除率98.7%(151/153);B组:高频电切组患者息肉一次性切除率为98%(147/150),P> 0.05。④UEMR组腹痛评分较高频电切组显著降低,差异有统计学意义(P <0.05);⑤UEMR组及对照组均无术中、术后穿孔病例,但UEMR组术中出血率2.61%(4/153),电切除组术中出血率7.3%(11/150),P <0.05。UEMR组出现迟发性出血病例为0例,电切除组迟发性出血出现1例。⑥息肉注水浸泡后,无蒂息肉基底部显露更佳、有蒂及亚蒂息肉蒂部暴露充分度良好,益于大肠息肉病情观察和临床治疗。结论注水法内镜下黏膜切除术(UEMR)治疗大肠息肉可在不影响手术成功率的同时,减少患者腹痛,增加患者耐受性,同时减少并发症的发生率,非常值得推广到临床应用。

Objective To compare the feasibility and safety of the underwater endoscopic mucosal resection(UEMR) and high frequency electric resection in the treatment of large intestine polyps. Methods From January 2016 to July 2017, selection of 200 patients with colon polyps,received it in accordance with the method of randomized divided into A group(underwater endoscopic mucosal resection group) and B group(high frequency electric resection), 100 cases in each group. The main outcome measures are patient's tolerance, operation success rate and intraoperative and postoperative complications. Results The clinical data between the three groups showed no significant difference(P >0.05);there was no significant difference between the two groups in the success rate of operation. The abdominal pain and in A group was significantly lower than that in B group (P <0.05), the intubation time and total operation time of A group was significantly more than B group, and the endoscopic assisted operation was less than that in B group (P <0.05). The complications in group A were lower than those in group B(P <0.05). Conclusion Compared the high frequency electric resection,the underwater endoscopic mucosal resection can reduce abdominal pain without affect the success rate of intubation and operation rate, it is worthy of clinical application.