内镜下冷圈套器切除术在儿童5~10 mm结肠息肉治疗中的应用

The application of cold snare polyppectomy in the treatment of 5-10 mm colonic polyps in children

目的比较分析内镜下冷圈套器切除术(CSP)与热圈套器切除术(HSP)治疗儿童5~10 mm结肠息肉的疗效及安全性。方法选取2018年6月至2022年6月江南大学附属儿童医院接受结肠镜检查发现直径5~10 mm息肉的118例患儿为研究对象,采用随机数字表法分为2组,分别采用CSP(CSP组)和HSP(HSP组)进行息肉切除,比较两组患儿单个息肉切除所需时间、术中出血率、术后出血率、腹部不适率、住院时间及费用等。结果118例患儿中,CSP组58例,男36例、女22例,平均年龄(6.17±3.34)岁;HSP组60例,男34例、女26例,平均年龄(5.68±3.18)岁;两组患儿性别、年龄差异均无统计学意义(P>0.05)。CSP组与HSP组相比,单个息肉切除时间更短[(6.68±0.34)min比(7.60±0.53)min],术后迟发出血率更低[0比10.0%],住院时间更短[(5.50±1.87)d比(6.38±1.38)d],住院费用更低[(7646.99±3575.10)元比(10006.47±3657.42)元];差异均有统计学意义(均P<0.05)。结论儿童5~10 mm结肠小息肉应用CSP可缩短手术治疗时间,减少术后并发症,减少患儿住院时间及费用,总体疗效肯定且安全,值得儿科医师在临床上推广应用。

Objective To compare the efficacy and safety of endoscopic cold snare polypectomy(CSP)and hot snare polypectomy(HSP)on 5 to 10 mm colonic polyps in children.Methods One hundred and eighteen children,who underwent colonoscopy at Children′s Hospital Affiliated to Jiangnan University from June 2018 to June 2022 and found polyps with a diameter of 5-10 mm,were selected as the study subjects.They were divided into two groups by random number table method,with CSP(CSP group)and HSP(HSP group)for polypectomy respectively.The time required to remove a single polyp,intraoperative bleeding rate,postoperative bleeding rate,abdominal discomfort rate,hospitalization time,and hospitalization costs were compared between two groups.Results Among 118 cases,there were 58 cases in CSP group,including 36 males and 22 females,with an average age of(6.17±3.34)years.There were 60 cases in HSP group,including 34 males and 26 females,with an average age of(5.68±3.18)years.There were no significant differences in sex and age between two groups(P>0.05).Compared with HSP group,the time required to remove a single polyp in CSP group was shorter[(6.68±0.34)min vs.(7.60±0.53)min],the rate of delayed postoperative bleeding was lower(0 vs.10.0%),the hospitalization time was shorter[(5.50±1.87)d vs.(6.38±1.38)d],and the hospitalization expenses were lower[(7646.99±3575.10)yuan vs.(10006.47±3657.42)yuan].The differences were statistically significant(all P<0.05).Conclusion The application of CSP to remove 5-10 mm colon polyps in children could shorten surgical treatment time and reduce the occurrence of complications.At the same time,it could reduce the hospitalization time and cost,and the overall effect is positive and safe,which is worthy of popularization and application by pediatricians in clinical practice.