3种手术治疗结直肠息肉的效果对比研究

Comparative Study on the Effect of Three Kinds of Surgery on Colorectal Polyps

目的对比结肠镜下高频电凝电切术、黏膜切除术及冷圈套息肉切除术治疗结直肠息肉的效果。方法将2020年4月—2022年4月山东省淄博市中心医院收治的126例结直肠息肉患者作为研究对象,按照手术方法的不同将其分为高频电凝电切术组(n=42)、黏膜切除术组(n=42)和冷圈套息肉切除术组(n=42)。对比三组术后临床指标、息肉切除效果以及并发症情况。结果冷圈套息肉切除术组手术时间、手术切口愈合时间以及术中出血量均优于高频电凝电切术组和黏膜切除术组(P<0.05);三组抗生素使用时间比较,差异无统计学意义(P>0.05);冷圈套息肉切除术组息肉完整切除率高于高频电凝电切术组和黏膜切除术组(P<0.05);而术后半年息肉复发率低于高频电凝电切术组和黏膜切除术组(P<0.05);三组标本回收率比较,差异无统计学意义(P>0.05);高频电凝电切术组、黏膜切除术组、冷圈套息肉切除术组并发症总发生率分别为11.90%、16.67%、9.52%,三组差异无统计学意义(P>0.05)。结论冷圈套息肉切除术相较于高频电凝电切术和黏膜切除术对于结直肠息肉可有效改善患者手术相关指标,提高息肉完整切除率,降低复发率。

Objective To compare the effects of high frequency electrocoagulation and electroresection under colonoscopy,mucosal resection and cold snare polyp resection in the treatment of colorectal polyps.Methods A total of 126 patients with colorectal polyps admitted to Zibo Central Hospital of Shandong Province from April 2020 to April 2022 were selected as subjects.According to different surgical methods,they were divided into high-frequency electrocoagulation electroresection group(n=42),mucosal resection group(n=42)and cold snare polyp resection group(n=42).The clinical indexes,polypectomy effect and complications of the three groups were compared.Results The operation time,incision healing time and intraoperative blood loss of the cold snare polyp resection group were all better than those of the high-frequency electrocoagulation electroresection group and the mucosal resection group(P<0.05),and there was no statistical significance in antibiotic use time among the three groups(P>0.05).The complete resection rate of polyps in cold snare polyp resection group was higher than that in high-frequency electrocoagulation electroresection group and mucosa resection group(P<0.05),and the recurrence rate of polyps half a year after surgery was lower than that in high-frequency electrocoagulation electroresection group and mucosa resection group(P<0.05).There was no significant difference in recovery rate among the three groups(P>0.05).The total incidence of complications was 11.90%,16.67%and 9.52%in the high-frequency electrocoagulation and electroresection group,mucosal resection group and cold snare polyp resection group,respectively,and there was no statistical significance among the three groups(P>0.05).Conclusion Compared with high-frequency electrocoagulation electroresection and mucosal resection,cold snare polyp resection can effectively improve the surgical indicators,increase the complete removal rate of polyps and reduce the recurrence rate of colorectal polyps.