结直肠息肉冷圈套切除术的临床疗效分析

Clinical Efficacy Analysis of Cold Snare Polypectomy for Colorectal Polyps

目的对内镜下冷圈套器息肉切除术(CSP)的临床疗效进行对照研究,评估CSP在结直肠息肉切除中的实用性、有效性及安全性,探讨其应用价值。方法收集2019年1月至2021年12月银川市第一人民医院肠镜检查中检出的直径3~10 mm息肉共694枚,按照息肉直径分成微小息肉组及小息肉组,对于微小息肉组,对照分析CSP及冷活检钳夹术(CFP)两种处理术式的完全切除率;对于小息肉组,对照分析CSP及内镜下黏膜切除术(EMR)两种处理术式的迟发性出血率、穿孔率及钛夹利用率。结果微小息肉组中CFP与CSP两种处理术式,息肉直径差异无统计学意义(P>0.05),CFP组息肉完全切除率为72.6%,低于CSP组的98.6%(P<0.05)。小息肉组中CSP与EMR处理术式在息肉直径、息肉完全切除率间差异无统计学意义(P均>0.05);CSP处理术式的迟发性出血率、穿孔率及钛夹利用率均低于EMR(P均<0.05)。结论在切除微小息肉时,CSP的完全切除率比CFP更高;在切除小息肉时,CSP比EMR更加安全、经济。CSP在切除结直肠微小息肉及小息肉时,具备更多的优势,可在临床上推广应用。

Objective To conduct a comparative study on the clinical efficacy of endoscopic cold snare polypectomy(CSP),evaluate the practicality,effectiveness,and safety of CSP in colon polypectomy,and to explore its application value.Methods A total of 694 polyps with sizes of 3-10 mm detected during colonoscopy at the First People’s Hospital of Yinchuan City from January 2019 to December 2021 were collected,and were divided into two groups based on the diameter of the polyps:micro polyps and small polyps.For the micro polyp group,a comparative analysis was conducted on the complete resection rate between CSP and cold forcep biopsy polypectomy(CFP).For the small polyp group,a comparative analysis was conducted on the delayed bleeding,perforation rate,and titanium clip utilization rate between CSP and endoscopic mucosal resection(EMR).Results In the micro polyp group,there was no statistically significant difference in polyp diameter between CFP and CSP treatment methods(P>0.05).The complete polypectomy rate in the CFP group(72.6%)was lower than that in the CSP group(98.6%)(P<0.05).In the small polyp group,there was no statistically significant difference between CSP and EMR treatments in polyp diameter and complete polypectomy rate(P all>0.05)and the delayed bleeding rate,perforation rate,and titanium clip utilization rate of CSP treatment were lower than those of EMR(P all<0.05).Conclusion CSP has a higher complete resection rate than CFP when removing micro polyps;CSP were safer and more economical than EMR when removing small polyps,and has more advantages when removing micro polyps and small polyps in the colon.It can be promoted and applied in clinical practice.