内镜下冷圈套器切除术在老年人结直肠小息肉的安全性及有效性的分析

Analysis of the Safety and Effectiveness of Endoscopic Cold Loop Resection for Small Colorectal Polyps in the Elderly

目的:观察并探讨老年人结直肠小息肉采取内镜下冷圈套器切除术的临床效果及运用安全性。方法:选择2022年1月~2022年6月于福建省老年医院消化内镜中心行结肠镜检查并发现结直肠小息肉(直径6~9mm)的老年患者的临床资料,总分析病例数71例,按不同的治疗方法分为内镜下圈套器冷切除术组(观察组),内镜下圈套器电凝电切除术(对照组),对不同方法诊疗效果展开测评,如手术参数、息肉切除状况及病理分型结果、并发症等。结果:(1)手术参数:息肉切除时间:观察组息肉切除时间相较于对照组低,差异有统计学意义(P<0.05);术中钛夹平均使用数量:观察组钛夹的平均使用数量相较于对照组少,差异有统计学意义(P<0.05);术中出血率:术中出血率比较,两组差异无统计学意义;(2)息肉切除状况:标本回收率方面:观察组、对照组比较差异无统计学意义(P>0.05),息肉完整切除率:观察组息肉完整切除率高于对照组;(3)术后相关指标:于息肉切除术后病理分型指标方面,两组比较无显著差异(P>0.05);(4)并发症:术后穿孔、出血及热灼伤发生率两组无统计学差异(P>0.05)。结论:老年人结直肠小息肉采取内镜下冷圈套器切除术诊疗效果优于内镜下圈套器电凝电切除术,可缩短手术时间,节约医疗成本,操作便捷,安全性高。

Objective:To observe and explore the clinical efficacy and safety of endoscopic cold snare resection for small colorectal polyps in the elderly.Methods:Clinical data of 71 elderly patients who underwent colonoscopy at the Digestive Endoscopy Center of Fujian Elderly Hospital from January 2022 to June 2022 and found small polyps(6-9mm in diameter)in the colon were analyzed.They were divided into two groups according to different treatment methods:endoscopic snare cold resection group(observation group)and endoscopic snare electrocoagulation resection group(control group).The diagnostic and therapeutic effects of different methods were evaluated,such as surgical parameters Polyp resection status,pathological classification results,complications,etc.Results:①Surgical parameters:polypectomy time:the polypectomy time in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05);The average number of titanium clips used during surgery:the average number of titanium clips used in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05);Intraoperative bleeding rate:there was no statistically significant difference between the two groups in terms of intraoperative bleeding rate;②Polyp resection status:in terms of specimen recovery rate,there was no statistically significant difference between the observation group and the control group(P>0.05).Polyp complete resection rate:the observation group had a higher polyp complete resection rate than the control group;③Postoperative related indicators:in terms of pathological classification indicators after polypectomy,there was no significant difference between the two groups(P>0.05);④Complications:there was no statistically significant difference in the incidence of postoperative perforation,bleeding,and thermal burns between the two groups(P>0.05).Conclusion:The diagnosis and treatment effect of endoscopic cold snare resection for small colorectal polyps in the elderly is better than endoscopic snare electrocoagulation resection,which can shorten surgical time,save medical costs,operate conveniently,and have high safety.