冷圈套切除术治疗老年结直肠息肉的临床效果研究

Study on the clinical effect of cold snare polypectomy in the treatment of colorectal polyps in the elderly

目的探究冷圈套切除术治疗老年结直肠息肉的临床效果,为治疗老年结直肠息肉提供方法。方法回顾性分析2017年1月~2019年12月期间安徽医科大学第三附属医院消化内科住院治疗的211例老年结直肠息肉患者的临床资料,依据不同治疗方法分为观察组(n=110)和对照组(n=101)。观察组息肉回收样本238粒,对照组息肉回收样本221粒。观察组接受冷圈套切除术(CSP)治疗,对照组接受热圈套术(HSP)治疗。评估并比较2组患者的疗效、并发症、手术指标值、术后病理分型及黏膜下小动脉损伤情况。结果观察组疗效显著高于对照组(P<0.05),并发症发生率较对照组明显降低(P<0.05),术后息肉切除处肠壁黏膜下小动脉损伤率明显低于对照组(P<0.05);观察组内镜操作时间、息肉切除时间及手术操作时间与对照组相比明显较短(P<0.05)。2组息肉病理分型的差异无统计学意义(P>0.05)。结论CSP术治疗老年结直肠息肉,疗效显著,缩短手术时间,提高切除率,降低周围组织损伤,具有一定的临床应用价值。

Objective To explore the clinical effect of cold snare polypectomy(CSP)in the treatment of colorectal polyps in the elderly and to provide a method for the treatment of this disease in the elderly.Methods The clinical data of 211 elderly patients with colorectal polyps who hospitalized in Department of Gastroenterology,Third Affiliated Hospital of Anhui Medical University from January 2017 to December 2019 were retrospectively analyzed.According to different treatment methods,they were divided into two groups:observation group(n=110)and control group(n=101).The observation group was treated with CSP and the control group was treated with hot snare resection(HSP).Among them,221 polyp samples were collected from the control group and 238 ones were collected from the observation group.The curative effect,complications,surgical operation indexes,postoperative pathological type and submucosal arteriole injury were evaluated and compared between the two groups.Results The curative effect of the observation group was significantly higher than that of the control group(P<0.05),the incidence of complications was significantly lower than that of the control group(P<0.05),and the injury rate of intestinal submucosal arterioles at polypectomy sites was significantly lower than that of the control group(P<0.05).The endoscopic operation time,polyp resection time and operation time of the observation group were significantly shorter than those of the control group(P<0.05).There was no significant difference in the pathological types of polyps between the two groups(P>0.05).Conclusion CSP has a significant curative effect on the colorectal polyps in the elderly patients.It can shorten the operation time,increase the resection rate,reduce the injury of surrounding tissues,and has a certain clinical application value.