内镜下不同圈套器切除术治疗直径≤1.0 cm结直肠息肉的效果及安全性观察

Effect and safety of polypectomy with endoscopic different snares in the treatment of colorectal polyps≤1.0 cm in diameter

目的探究内镜下不同圈套器切除术治疗直径≤1.0 cm结直肠息肉的效果及安全性。方法前瞻性选取2021年5月至2022年7月忻州市中医医院收治的128例直径≤1.0 cm的结直肠息肉患者作为研究对象,采用随机数字表法将其分为热圈套切除术(HSP)组与冷圈套切除术(CSP)组,各64例,分别采用HSP与CSP治疗。比较两组患者息肉情况(息肉数量、直径、位置)、治疗效果(息肉切除时间、息肉回收率、完整息肉切除率、完全切除率、钛夹使用例数)、并发症发生情况。结果两组的息肉数量、息肉直径、息肉位置比较,差异均无统计学意义(P>0.05)。CSP组息肉切除时间为(2.31±0.43)min,显著短于HSP组[(3.06±0.51)min],钛夹使用例数为9.38%(6/64),少于HSP组[21.88%(14/64)],差异均有统计学意义(P<0.05)。两组息肉回收率、完整息肉切除率以及完全切除率比较,差异均无统计学意义(P>0.05)。两组围手术期发生的并发症包括术中出血、电凝综合征、迟发出血以及腹部不适,CSP组术中出血发生率为28.13%高于HSP组(10.94%),电凝综合征以及迟发出血发生率分别为0、0,均低于HSP组(9.38%、9.38%),差异均有统计学意义(P<0.05),两组腹部不适发生率比较,差异无统计学意义(P>0.05)。结论CSP与HSP治疗直径≤1.0 cm的结直肠息肉比较,前者可显著缩短手术切除时间并且降低电凝综合征、迟发出血等并发症发生率,安全性高,可用于临床推广。

Objective To explore the effect and safety of polypectomy with endoscopic different snares in the treatment of colorectal polyps≤1.0 cm in diameter.Methods A total of 128 patients with colorectal polyps≤1.0 cm in diameter who were admitted to Xinzhou Traditional Chinese Medicine Hospital from May 2021 to July 2022 were selected as the research subjects,and divided into the hot snare polypectomy(HSP)group and the cold snare polypectomy(CSP)group by random number table method,with 64 cases in each group.The condition of polyps(number,diameter,and position of polyps),curative effect(polypectomy time,polyp recovery rate,recycle rate of polyps,complete polypectomy rate or complete polypectomy rate,titanium clips used)and complications were compared between the two groups.Results There were no significant differences in number,diameter and sites of polyps between the two groups(P>0.05).The polypectomy time in CSP group was(2.31±0.43)min,which was significantly shorter than that in HSP group[(3.06±0.51)min],and titanium clips used was 9.38%(6/64),which was fewer than that in HSP group[21.88%(14/64)],the differences were statistically significant(P<0.05).There were no significant differences in recycle rate of polyps,complete polypectomy rate or complete polypectomy rate between the two groups(P>0.05).There were perioperative complications in both groups,including intraoperative bleeding,electrocoagulation syndrome,delayed bleeding and abdominal discomfort.The incidence of intraoperative bleeding in CSP group was 28.13%,which was higher than that in HSP group(10.94%),and incidence of electrocoagulation syndrome and delayed bleeding was 0,0,lower than that in HSP group(9.38%,9.38%),the differences were statistically significant(P<0.05).There was no significant difference in the incidence of abdominal discomfort between the two groups(P>0.05).Conclusion Compared with HSP,CSP can significantly shorten polypectomy time and reduce the incidence of complications(electrocoagulation syndrome,delayed bleeding)in colorectal polyps≤1.0 cm,with high safety.