冷圈套器息肉切除术、热圈套器息肉切除术与内镜下黏膜切除术对结直肠小息肉完整切除率与出血率的影响对比

Comparison of Effects of Cold Snare Polypectomy,Hot Snare Polypectomy and Endoscopic Mucosal Polypectomy on Complete Resection Rate and Bleeding Rate of Colorectal Small Polyps

目的:分析用冷圈套器息肉切除术(CSP)、热圈套器息肉切除术(HSP)与内镜下黏膜切除术(EMR)治疗对结直肠小息肉完整切除率及出血率的影响。方法:将2020年1月~2022年12月本院收治的结直肠小息肉患者60例作为观察对象,按照患者手术方式的不同分为EMR组(EMR,20例)、HSP组(HSP,20例)、CSP组(CSP,20例),比较分析三组分别治疗后息肉完整切除率(息肉整块切除、组织学完全切除)、出血率、VEGF、TXB2水平。结果:手术开展前,EMR组、HSP组、CSP组VEGF、TXB2水平对比无统计学意义(P>0.05),手术完成后,EMR组患者VEGF、TXB2水平、出血率明显更低于HSP组与CSP组,组织学完全切除率更高于HSP、CSP两组,HSP、CSP两组间VEGF、TXB2水平、出血率与组织学完全切除率对比有统计学意义(P<0.05);但三组间息肉整块切除率对比无统计学意义(P>0.05)。结论:在结直肠小息肉患者临床治疗中对其采取CSP、HSP与EMR技术治疗均能切除整块息肉,但EMR技术更有利于提高组织学完全切除率,较HSP与CSP技术更有利于改善VEGF、TXB2水平。

Objective:To analyze the effects of cold snare polypectomy(CSP),hot snare polypectomy(HSP)and endoscopic mucosal resection(EMR)on the complete resection rate and bleeding rate of small colorectal polyps.Methods:60 patients with small colorectal polyps admitted to our hospital in recent years(January 2020 to December 2022)were divided into group EMR(EMR,20 cases),group HSP(HSP,20 cases),and group CSP(CSP,20 cases)according to different surgical methods.The complete polypectomy rate(polypectomy,histologic complete resection),bleeding rate,VEGF and TXB2 levels of the three groups were compared and analyzed after treatment.Results:Before the operation,the levels of VEGF and TXB2 in group EMR,group HSP and group CSP were not statistically significant(P>0.05).After the operation,the levels of VEGF and TXB2 and the bleeding rate in group EMR were significantly lower than those in group HSP and group CSP,and the histological complete resection rate was higher than that in group HSP and group CSP.The levels of VEGF,TXB2,bleeding rate and histological complete resection rate between HSP and CSP groups were statistically significant(P<0.05).However,there was no significant difference in polypectomy rate among the three groups(P>0.05).Conclusion:CSP,HSP and EMR can remove the whole polyp in the clinical treatment of patients with small colorectal polyps,but EMR technology is more conducive to improve the histological complete resection rate,and is more conducive to improve the level of VEGF and TXB2 than HSP and CSP technology.