冷圈套器切除术治疗右半结肠浅表型息肉的安全性分析

Safety of cold snare polypectomy for right half colon superficial polyps

目的 观察冷圈套器切除术与热圈套器切除术治疗右半结肠浅表型(即巴黎分型0-Ⅱa型)息肉的应用效果。方法 纳入110例右半结肠息肉患者,随机分为对照组和研究组,各55例,研究组采用冷圈套器切除术,对照组采用热圈套器切除术,分析两组患者治疗和随访情况。结果 研究组与对照组内镜下完全切除率分别为97.10%和95.65%,术中和术后均未出现出血和穿孔等并发症,研究组术后无持续性腹痛,对照组有3例患者可能是电凝综合征或注射针穿透损伤肠壁,引起局限持续性腹痛,最长达1个月。研究组治疗时间短于对照组,治疗费用少于对照组,差异均有统计学意义(P <0.05)。结论 冷圈套器切除术治疗<1 cm的右半结肠0-Ⅱa型息肉,较热圈套器切除术操作更便捷,内镜下切除率高,操作中避免了电刀电凝及注射针注射引起的透壁性损伤风险,降低了术后持续腹痛发生率,不增加出血和穿孔的风险,治疗过程安全,治疗时间短,费用低,临床疗效好。值得临床推广应用。

Objective To observe the effect of cold snare and hot snare polypectomy for right half colon superficialpolyps(type 0-IIa).Methods Randomized controlled studies comparing cold snare and hot snare polypectomy for removal of 110 patients with right half colon polyps were considered.The study group was treated with cold snare polypectomy,while the control group was treated with hot snare polypectomy,55 cases in each group.The treatment and follow-up of the two groups were analyzed.Results The polyscomplete resection rate of the study group and the control group were 97.10%and 95.65%,respectively.No bleeding or perforation complications occurred during or after surgery.There was no persistent postoperative abdominal pain in the study group,while 3 cases in the control group have localized abdominal pain lasting up to 1 month may due to electrocoagulation syndrome or injection needle penetration injury to the intestinal wall.The therapy time in the study group was shorter than that in the control group,the cost of therapy in the study group was less than that in the control group,and the difference were statistically significant(P<0.05).Conclusion Compared with hot snare polypectomy,cold snare polypectomy is more convenient to remove right colon type 0-IIa polyps within 1 cm in size, which has high endoscopic complete resection rate, and avoiding the risk of transmural injury caused byelectrocautery coagulation and needle injection, reducing the probability of persistent abdominal pain occurredpostoperatively, does not increase the risk of bleeding and perforation. The therapy is safer, the time of cold snarepolypectomy is shortened and the cost is reduced, and the clinical effect is good. It is worth popularizing andapplying.