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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2014年08期

页码:

615-618

栏目:

论著

出版日期:

2014-11-30

文章信息/Info

Title:

The clinical efficacy for colon polyps using argon plasma coagulation and high-frequency electric snare resection

作者:

徐涛; 赵燕颖; 孙远杰

一汽总医院，长春130011

Author(s):

XU Tao;  ZHAO Yan－ying;  SUN Yuan－jie

Yiqi General Hospital, Changchun, 13011, China Corresponding author: SUN Yuan-jie, E-mail: sunyuanjie0804@163.com

关键词:

结肠息肉; 氩离子凝固术; 高频电圈套切除术; 疗效; 安全性

Keywords:

Colonic polyps; Argon plasma coagulation; High- frequency electric snare resection; Efficacy;  Safety

分类号:

R656.9

DOI:

-

摘要:

目的比较分析氩离子凝固术（APC） 与高频电圈套切除术治疗结肠息肉的临床效果及安全性。方 法结肠息肉患者422 例（732 枚），按照治疗方法不同分为APC 组212 例（369 枚）、高频组210 例（363 枚）。两组均于术前行病理活检确定病理类型后进行手术治疗， APC 组采用氩离子凝固术， 高频组采用 高频电圈套切除术； 术后两组均随访2 个月， 评估各组治愈率， 出血、穿孔等并发症的发生率。采用 SPSS 17.0 统计软件，计量资料比较采用t 检验，计数资料采用χ2 检验。P<0.05 为差异有统计学意义。结 果APC 组和高频组总治愈率分别为91.06% （336/369） 和89.53% （325/363）， 差异无统计学意义（P> 0.05）；无蒂型结肠息肉的治愈率分别为100%(145/145)和80.14%(117/146)，APC 组的切除效果优于高频组 （P<0.01）；亚蒂型及有蒂型结肠息肉的治愈率分别85.27%(191/224)和95.85%(208/217)，高频组的切除效 果优于APC 组（P<0.05）。随访2 个月，APC 组发生迟发性出血7 例，并发症发生率3.30% （7/212）；高 频组发生迟发性出血23 例（10.95%）、穿孔1 例，并发症发生率11.43% （24/210）；两组出血发生率及并发 症总发生率比较差异均有统计学意义（P 均<0.01）。结论氩离子凝固术对于无蒂型结肠息肉的治疗效果 较佳，且出血少；高频电圈套切除术更适于应用于亚蒂型及有蒂型结肠息肉。

Abstract:

Objective To analyze effects and safety of Argon Plasma Coagulation (APC) and high-frequency electric snare resection for colon polyps. Methods There were 422 patients with 732 colon polyps in this sample. The patients were divided into 2 groups, 212 cases (369 colon polyps) in APC group and 210 cases (363 colon polyps) in high- frequency group. The pathological types of polyps in both groups were determined by the preoperative biopsy. Patients in APC group were treated by argon plasma coagulation, and patients in high- frequency group were treated by high frequency electric snare resection. All patients were followed up after two months. The cure rate, incidence of bleeding, perforation and other complications were evaluated at follow-up. SPSS 17.0 was used to analyze the data. Ttest was used to analyze continuous variables and Chi-square was used to analyze category variables between two groups. P<0.05 was used for statistical significant. Results The cure rate for APC group and high-frequency group were 91.06% (336/369) and 89.53% (325/363) respectively. There was no statistically significant difference. The cure rates of flat and superficial uplift colon polyps were 100% (145/ 145) and 80.14% (117/146) for APC group and high- frequency group. The removal effect of APC group was significantly better than the high-frequency group (P<0.01). The cure rates of rebagliati andpedunculated type colon polyps were 85.27%(191/224) and 95.85%(208/217); the removal effect of highfrequency group was significantly better than the APC group (P<0.05). At two month follow-up, 7 patients occurred delayed bleeding and the complication rate was 3.30% (7/212) in APC group; 23 patients occurred delayed bleeding and 1 patient occurred perforation, and the complication rate was 11.43% (24/ 210) in high-frequency group. The differences of delayed bleeding and complications occurrence between two groups were statistically significant (P<0.01). Conclusions Argon plasma coagulation has better therapeutic effect on flat and superficial uplift colon polyps and will cause less bleeding complications. Frequency electric snare resection has better effect on rebagliati and pedicle colon polyps.

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备注/Memo

备注/Memo:

作者简介：徐涛，大学本科，副主任医师，主要从事胃肠道疾病、药物性肝病、内镜下胃肠道疾病的诊治工作 通信作者：孙远杰，E-mail: sunyuanjie0804@163.com

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更新日期/Last Update: 2014-11-30