摘要
目的:探讨内镜下黏膜切除术部分联合金属钛夹治疗结直肠腺瘤的效果。方法:对2016年6月~2018年2月64例结直肠腺瘤患者进行内镜下黏膜切除术治疗,其中42例患者联合金属夹夹闭,另22例患者未联合金属夹夹闭。结果:术后病理证实:64例结直肠腺瘤患者中,管状腺瘤31例(48.44%),绒毛状腺瘤23例(36.94%),管状绒毛状腺瘤10例(15.63%),高级别上皮内瘤变9例(14.06%)。均一次性完全切除,术中7例出血较明显,均用活检钳钳夹、金属夹夹闭成功止血。42例患者联合金属夹夹闭,术后未见延迟出血、消化道穿孔等并发症发生。另22例未联合金属夹夹闭,术后发生2例(9.09%)延迟出血。联合金属夹夹闭的患者术后延迟出血发生率与未联合金属夹夹闭者比较无统计学意义(P>0.05)。直至最近一次随访,复查结肠镜,两组均无一例复发。结论:对于部分内镜下黏膜切除术的结直肠腺瘤,应选择性地使用金属钛夹治疗,不仅不会明显提高术后出血的发生率,还能够节省金属夹的使用,缩短手术时间,减少医疗耗材。
Objective:To explore the effect of endoscopic mucosal resection combined with metal titanium clips on colorectal adenoma.Methods:Sixty-four patients with colorectal adenoma from June 2016 to February 2018 underwent endoscopic mucosal resection.42 patients were combined with metal clips and 22 patients were not combined with metal clips.Results:Postoperative pathology confirmed that among 64 patients with colorectal adenomas,31 were tubular adenomas(48.44%),23 were villous adenomas(36.94%),and 10 were villous adenomas(15.63%).9 cases of grade intraepithelial neoplasia(14.06%).All cases were completely resected at one time,and the bleeding in 7 cases was more obvious during operation.All of them were successfully stopped with biopsy forceps and metal clips.Forty-two patients were combined with metal clips,and no complications such as delayed bleeding and gastrointestinal perforation occurred.The other 22 cases were not combined with metal clips,and delayed bleeding occurred in 2 cases(9.09%)after operation.The incidence of postoperative delayed bleeding in patients with metal clips was not statistically significant compared with those without metal clips(P>0.05).Up to the latest follow-up,colonoscopy was reviewed,and no recurrence was found in either group.Conclusion:For colorectal adenomas undergoing partial endoscopic mucosal resection,metal titanium clips should be used selectively,which will not only significantly increase the incidence of postoperative bleeding,but also save the use of metal clips and shorten the operation time.Reduce medical supplies.
作者
张帆
ZHANG Fan(Department of Gastroenterology,Dandong Central Hospital,Liaoning Dandong 118000)
出处
《中国医疗器械信息》
2020年第2期163-164,共2页
China Medical Device Information
关键词
内镜下黏膜切除术
金属钛夹
结直肠腺瘤
endoscopic mucosal resection
metal titanium clip
colorectal adenoma
