电子结肠镜下冷圈套切除术与高频电凝切除术治疗结直肠小息肉的效果比较

Comparison of the effects of cold snare resection and high frequency electrocoagulation resection under electronic colonoscopy in the treatment of small colorectal polyp

目的比较电子结肠镜下冷圈套切除术与高频电凝切除术治疗结直肠小息肉的临床效果。方法选取2017年1月至2019年1月我院肠镜室收治的126例结直肠小息肉患者作为研究对象,采用随机数字表法将其分为对照组和研究组,各63例。对照组患者接受电子结肠镜下高频电凝切除术治疗,研究组患者接受电子结肠镜下冷圈套切除术治疗。比较两组患者的息肉切除手术情况、息肉位置与NICE分型、息肉完全切除率与标本回收率及术后病理检查结果;随访24个月后,比较两组患者的累计复发率。结果研究组的息肉切除时间显著短于对照组,差异具有统计学意义(P<0.05);两组的息肉切除数、息肉直径、术中出血率及迟发型出血率比较,差异无统计学意义(P>0.05)。两组患者的息肉位置与NICE分型比较,差异均无统计学意义(P>0.05)。研究组不同直径的息肉完全切除率均显著高于对照组,差异具有统计学意义(P<0.05);两组的息肉标本回收率比较,差异无统计学意义(P>0.05)。两组患者的病理分型及异型性比较,差异均无统计学意义(P>0.05);对照组的黏膜下累及损伤发生率显著高于研究组,差异具有统计学意义(P<0.05)。术后随访24个月,研究组患者的累计复发率显著低于对照组,差异具有统计学意义(P<0.05)。结论在结直肠小息肉治疗中,电子结肠镜下冷圈套切除术较高频电凝切除术具有优势手术时间短、息肉完全切除率高、不损伤肠黏膜、复发率低等优势,值得推广。

Objective To compare the clinical effects of cold snare resection and high frequency electrocoagulation resection under electronic colonoscopy in the treatment of small colorectal polyp.Methods A total of 126 patients with small colorectal polyp treated in the colonoscopy room of our hospital from January 2017 to January 2019 were selected as the research objects.The patients were divided into control group and study group by random number table method,with 63 cases in each group.The patients in the control group received high frequency electrocoagulation resection under electronic colonoscopy,and the patients in the study group received cold snare resection under electronic colonoscopy.The polyp resection,polyp location and NICE classification,complete resection rate of polyp,specimen recovery rate and postoperative pathological examination results of the two groups were compared,and the cumulative recurrence rate of the two groups was compared after 24 months of follow-up.Results The polyp resection time in the study group was significantly shorter than that in the control group,and the difference was statistically significant(P<0.05);there were no significant differences in the number of polyp resection,the diameter of polyp,the intraoperative bleeding rate and the delayed onset bleeding rate between the two groups(P>0.05).There were no significant differences in polyp location and NICE classification between the two groups(P>0.05).The complete resection rate of polyps of different diameters in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in the specimen recovery rate of polyp between the two groups(P>0.05).There were no significant differences in pathological typing and atypia between the two groups(P >0.05);the incidence of submucosal involvement injury in the control group was significantly higher than that in the study group,and the difference was statistically significant(P <0.05).After 24 months of follow-up,the cumulative recurrence rate in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of small colorectal polyp,cold snare resection under electronic colonoscopy has the advantages of short operation time,high complete resection rate of polyp,no damage to intestinal mucosa and low recurrence rate compared with high frequency electrocoagulation resection,which is worthy of popularization.