高频电切结合黏膜下注射治疗结肠息肉临床观察

Clinical observation of high frequency electric resection combined with submucosal injection for treatment of colon polyps

目的探讨高频电切结合黏膜下注射治疗结肠息肉的安全性。方法选择我院自2016年8月~2017年8月结肠息肉患者共160例,随机分为对照组(n=76)和观察组(n=84)两组。对照组直接用高频电切除结肠息肉;观察组先给予息肉根部黏膜下注射后,再行高频电切除。比较两组高频电切除后肠穿孔及术后出血的发生率。使用小探头超声对两组治疗前后的超声影像进行对比,观察结肠壁各层的损伤情况。结果对照组肠穿孔发生率7.89%(6/76),观察组肠穿孔发生率为0(0/84),观察组明显优于对照组(P<0.05)。超声内镜显示对照组高频电治疗后黏膜层与黏膜下层融合、层次不清,提示固有肌层损伤。观察组治疗后提示固有肌层完整。结论黏膜下注射对高频电治疗具有保护作用,可减少结肠息肉患者高频电治疗发生穿孔的概率。

Objective To investigate the safety of high frequency electric resection combined with submucosal injection for colon polyps. Methods A total of 160 patients with colon polyps in our hospital from August 2016 to August 2017 were randomly divided into the control group (76 cases) and the observation group(84 cases). The control group was directly used high-frequency electric resection of colon polyps. The observation group was given submucosal injection of polyps roots, and then high-frequency electric resection. The incidence of intestinal perforation and postoperative bleeding after high-frequency electric resection was compared between the two groups. Ultrasound images of the two groups before and after treatment were compared using small probe ultrasound. The damage of various layers of the colon wall was observed. Results The incidence of intestinal perforation in the control group was 7.89%(6/76). The incidence of intestinal perforation in the observation group was 0(0/84), which was significantly better than that of the control group(P<0.05). Endoscopic ultrasonography showed that the mucosal layer and the submucosa were fused and the layer was unclear after high-frequency electrotherapy in the control group, suggesting that the intrinsic muscular layer was damaged. The observation group showed the integrity of the intrinsic muscular layer after treatment. Conclusion Submucosal injection has a protective effect on high frequency electrotherapy, which can reduce the probability of perforation of high frequency electrotherapy in patients with colon polyps.