探讨3种不同内镜方式治疗结肠息肉的疗效

To Explore the Efficacy of Three Different Endoscopic Methods in the Treatment of Colonic Polyps

目的探讨结肠镜下内镜下氩离子凝固疗法(APC)、内镜下高频电切术及内镜下黏膜切除术(EMR)治疗结肠息肉的疗效。方法收集该科于2016年4月—2018年4月之间电子结肠镜检查的临床资料,其中检出结肠息肉700枚。给予700枚结肠息肉行结肠镜下治疗,分别采用氩离子凝固术(APC)治疗300枚,高频电切术治疗150枚,内镜下黏膜切除术(EMR)治疗250枚。术后观察至3个月,比较这3种方法的临床治愈率及术后并发症。结果治疗浅表隆起的结肠息肉,APC组治愈率98.77%及EMR组治愈率95.38%明显优于高频电切组治愈率60.71%(P<0.05),而APC组和EMR组之间差异无统计学意义(P>0.05)。治疗有蒂隆起的结肠息肉,高频电切组治愈率92.53%、EMR组治愈率99.16%明显优于APC组治愈率69.57%(P<0.05);而高频电切组和EMR组之间差异无统计学意义(P>0.05)。结论APC在治疗浅表隆起的结肠息肉方面有优势;高频电圈套器切除可治疗有蒂的结肠息肉。EMR适用于治疗各种息肉。

Objective To investigate the efficacy of argon plasma coagulation (APC) under colonoscopy, high-frequency electrotomy under endoscopy and mucosal resection (EMR) for colon polyps. Methods A total of 700 patients with colon polyps were treated with colonoscopy. Among them, 300 were treated with argon plasma coagulation(APC), 150 were treated with high-frequency electrotomy, and 250 were treated with endoscopic mucosal resection(EMR). The clinical cure rates and postoperative complications of these three methods were compared after 3 months of observation. Results The cure rate of APC group 98.77% and EMR group 95.38% was significantly better than that of the high-frequency electrotomy group cure rate 60.71% in the treatment of superficial uplifted colon polyps(P<0.05), while there was no statistical significance between APC group and EMR group(P>0.05). For the treatment of colonic polyps with pedicle eminence, the cure rate of the high frequency electrotomy group (92.53%) and EMR group (99.16%) was significantly better than that of the APC group (69.57%)(P<0.05). However, there was no statistical significance between the high-frequency electrotomy group and the EMR group(P>0.05). Conclusion APC has advantages in the treatment of superficial colonic polyps. High frequency electrical snare resection can treat pedicled colonic polyps. EMR is suitable for the treatment of various polyps.