内镜下冷圈套器切除术与冷活检钳钳除术治疗结肠微小息肉的临床疗效比较

Comparison of Clinical Efficacy of Endoscopic Cold Snare Polypectomy and Cold Biopsy Forceps for Treatment of Small Polyps of Colon

目的比较内镜下冷圈套器切除术(CSP)与冷活检钳钳除术(CBF)治疗结肠微小息肉的临床疗效。方法选取2018年1月至2022年1月在联勤保障部队第九八〇医院与河北省中医院经内镜检查确诊为结肠微小息肉的161例患者作为研究对象,按照治疗方法不同分为CSP组(80例,息肉数90枚)和CBF组(81例,息肉数93枚)。其中,CSP组采用CSP治疗,CBF组采用CBF治疗。比较两组手术指标(切除息肉时间、标本回收率和完整切除率)、炎症因子水平[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平变化,以及并发症(术中出血、术后出血、穿孔)发生情况、复发情况和新生息肉数。结果CSP组的切除息肉时间明显长于CBF组[(242±11)s比(226±12)s],完整切除率明显高于CBF组[97.78%(88/90)比90.32%(84/93)](P<0.01或P<0.05)。与术前相比,术后两组患者的血清IL-6、TNF-α水平均下降(P<0.05),但组间比较差异无统计学意义(P>0.05)。两组总并发症发生率比较差异无统计学意义(χ^(2)=1.198,P=0.274)。CSP组的复发率明显低于CBF组[26.25%(21/80)比41.98%(34/81)](P<0.05),但两组的新生息肉数比较差异无统计学意义(P>0.05)。结论与CBF相比,CSP完整切除率更高、复发率更低,不增加并发症发生率,但息肉切除时间更长。

Objective To compare the clinical efficacy of endoscopic cold snare polypectomy(CSP)and cold biopsy forceps(CBF)in the treatment of small polyps of the colon.Methods A total of 161 patients with colon polyps diagnosed through endoscopic examinationat the 980th Hospital of the PLA Joint Logistic Support Force and Hebei Provincial Hospital of Traditional Chinese Medicine from Jan.2018 to Jan.2022 were included.They were divided into a CSP group(80 cases,90 polyps)and a CBF group(81 cases,93 polyps)according to different treatment methods.The CSP group was treated with CSP,and the CBF group was treated with CBF.The changes of surgical indicators(polyp resection time,specimen recovery rate and complete resection rate),inflammatory factor levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and complications(intraoperative bleeding,postoperative bleeding and perforation),recurrence and number of new polyps were compared between the two groups.Results The polypectomy time in the CSP group was significantly longer than that in the CBF group[(242±11)s vs(226±12)s],and the complete resection rate was significantly higher than that in the CBF group[97.78%(88/90)vs 90.32%(84/93)](P<0.01 or P<0.05).Compared with the preoperative level,the serum levels of IL-6 and TNF-αwere decreased in both groups after surgery(P<0.05),but there was no statistically significant difference between groups(P>0.05).There was no statistically significant difference in the overall incidence of complications between the two groups(χ^(2)=1.198,P=0.274).The recurrence rate of the CSP group was significantly lower than that of the CBF group[26.25%(21/80)vs 41.98%(34/81)](P<0.05),but there was no statistically significant difference in the number of newly formed polyps between the two groups(P>0.05).Conclusion Compared with CBF,CSP has a higher complete resection rate,lower recurrence rate,and does not increase the incidence of complications,but the polyp resection time is longer.