经内镜高频电凝电切术治疗胃肠道小息肉的预后分析(1)
【摘要】 目的 观察经内镜高频电凝电切术治疗胃肠道小息肉的临床疗效和预后情况。方法 选取50例胃肠道小息肉(直径<10 mm)患者作为研究对象， 均采取内窥镜下电凝切除术治疗后， 观察预后情况。结果 50例胃肠道小息肉的患者中， 病理检查结果除1例绒毛状腺瘤高级别上皮内瘤变者外， 其余均为良性病变， 单发为主， 在1年的随访后， 经胃肠镜检查无复发， 术后仅有1例患者便血， 其余患者均无不适症状。<5 mm组中病理类型、息肉数量、有无高血压等患者与6～9 mm组比较， 差异无统计学意义(P>0.05)；<5 mm组中有蒂息肉患者例数少于6～9 mm组， 差异有统计学意义(P<0.05)。<5 mm组中出血、穿孔及复发的患者与6～9 mm组比较， 差异无统计学意义(P>0.05)。结论 在针对胃肠道小息肉治疗中， 高频电凝电切术是一种安全、可行， 且对患者心理和身体伤害较小的治疗方法。
【关键词】 高频电凝电切术；胃肠道小息肉；内镜；预后分析；病理分型；出血
DOI：10.14163/j.cnki.11-5547/r.2017.08.020
【Abstract】 Objective To observe the clinical curative effect and prognosis of endoscopic high frequency electric coagulation electrocision in the treatment of gastrointestinal tract small polyps. Methods A total of 50 gastrointestinal tract small polyps (diameter<10 mm) patients as study subjects all were treated by endoscopic high frequency electric coagulation electrocision， and their prognosis was observed. Results Among 50 gastrointestinal tract small polyps patients， pathological examination results showed 1 case of villous adenomas high-grade intraepithelial neoplasia， and the rest were benign lesions， giving priority to single lesions. After 1 year of follow-up， no recurrent cases were shown by gastrointestinal endoscopy， only 1 patient with postoperative hematochezia， and the remaining patients had no uncomfortable symptoms. <5 mm group had no statistically significant difference in pathological types， number of polyps， with or without hypertension cases comparing with 6～9 mm group (P>0.05). <5 mm group had less tiffany polyps cases than 6～9 mm group， and the difference had statistical significance (P<0.05). <5 mm group had no statistically significant difference in bleeding， perforation and recurrent cases comparing with 6～9 mm group (P>0.05). Conclusion For the treatment of gastrointestinal tract small polyps， high frequency electric coagulation electrocision is a safe， feasible treatment method with small mental and physical harm to patients.
【Key words】 High frequency electric coagulation electrocision； Gastrointestinal tract small polyps； Endoscopic； Prognostic analysis； Pathological type； Bleeding
胃腸道息肉由于黏膜慢性炎症， 引起黏膜局部增生肥厚而形成在黏膜上的隆起样病变， 其特点是病程长且起病隐匿。在临床上仅有少数表现为大便习惯改变、带血和黏液， 次数增多， 和其他不同程度的腹部不适；该病多数症状不典型， 不易被发现[1]。但其由于有癌变倾向而受到临床关注， 其癌变的可能性与息肉的病理类型相关[2]， 与疾病的预后息息相关。随着近年来内镜技术的普及， 胃肠道息肉的检出率逐渐提高， 尤其是小息肉(直径<10 mm)， 本文就内镜下经高频电凝电切术治疗胃肠道小息肉的临床应用进行观察。详情报告如下。
1 资料与方法
1. 1 一般资料 选取本院在2014年7月～2015年7月收治的50例胃肠道小息肉患者， 其中男34例， 女16例；年龄20～70岁， 平均年龄(42±10)岁。临床表现为便血、黏液便及不同程度的腹部不适；息肉部位：胃息肉29例40枚， 肠道21例35枚。纳入标准：①经胃肠内镜镜确诊为息肉， 且息肉直径<10 mm；②息肉经内镜电凝电切术治疗； ③小息肉均送检病理科， 有明确的病理分型；④患者有不间断的随访记录。, 百拇医药(徐威)
【关键词】 高频电凝电切术；胃肠道小息肉；内镜；预后分析；病理分型；出血
DOI：10.14163/j.cnki.11-5547/r.2017.08.020
【Abstract】 Objective To observe the clinical curative effect and prognosis of endoscopic high frequency electric coagulation electrocision in the treatment of gastrointestinal tract small polyps. Methods A total of 50 gastrointestinal tract small polyps (diameter<10 mm) patients as study subjects all were treated by endoscopic high frequency electric coagulation electrocision， and their prognosis was observed. Results Among 50 gastrointestinal tract small polyps patients， pathological examination results showed 1 case of villous adenomas high-grade intraepithelial neoplasia， and the rest were benign lesions， giving priority to single lesions. After 1 year of follow-up， no recurrent cases were shown by gastrointestinal endoscopy， only 1 patient with postoperative hematochezia， and the remaining patients had no uncomfortable symptoms. <5 mm group had no statistically significant difference in pathological types， number of polyps， with or without hypertension cases comparing with 6～9 mm group (P>0.05). <5 mm group had less tiffany polyps cases than 6～9 mm group， and the difference had statistical significance (P<0.05). <5 mm group had no statistically significant difference in bleeding， perforation and recurrent cases comparing with 6～9 mm group (P>0.05). Conclusion For the treatment of gastrointestinal tract small polyps， high frequency electric coagulation electrocision is a safe， feasible treatment method with small mental and physical harm to patients.
【Key words】 High frequency electric coagulation electrocision； Gastrointestinal tract small polyps； Endoscopic； Prognostic analysis； Pathological type； Bleeding
胃腸道息肉由于黏膜慢性炎症， 引起黏膜局部增生肥厚而形成在黏膜上的隆起样病变， 其特点是病程长且起病隐匿。在临床上仅有少数表现为大便习惯改变、带血和黏液， 次数增多， 和其他不同程度的腹部不适；该病多数症状不典型， 不易被发现[1]。但其由于有癌变倾向而受到临床关注， 其癌变的可能性与息肉的病理类型相关[2]， 与疾病的预后息息相关。随着近年来内镜技术的普及， 胃肠道息肉的检出率逐渐提高， 尤其是小息肉(直径<10 mm)， 本文就内镜下经高频电凝电切术治疗胃肠道小息肉的临床应用进行观察。详情报告如下。
1 资料与方法
1. 1 一般资料 选取本院在2014年7月～2015年7月收治的50例胃肠道小息肉患者， 其中男34例， 女16例；年龄20～70岁， 平均年龄(42±10)岁。临床表现为便血、黏液便及不同程度的腹部不适；息肉部位：胃息肉29例40枚， 肠道21例35枚。纳入标准：①经胃肠内镜镜确诊为息肉， 且息肉直径<10 mm；②息肉经内镜电凝电切术治疗； ③小息肉均送检病理科， 有明确的病理分型；④患者有不间断的随访记录。, 百拇医药(徐威)