【摘要】 目的探讨不同技术和不同治疗附件相结合于结肠镜下高频电切除结肠息肉的可行性。方法以高频电为主体,配合热活检钳、圈套器及黏膜下注射技术,采用不同方法在电子结肠镜下对1500例病人的3875枚各种类型结肠息肉拟行切除。结果共有3851枚结肠息肉被切除,息肉切除率99.4%,其中腺瘤性息肉2360枚(61.3%)。在被切除的息肉中,热活检钳灼除2447枚(63.5%),直接圈套切除1274枚(33.1%),黏膜下注射后圈套切除38枚(1.0%),分次息肉圈套切除47枚(1.2%),圈套器电凝45枚(1.2%)。在被切除的息肉中,2 627枚(68.2%)无蒂,582枚(15.1%)为亚蒂,642枚(16.7%)为长蒂;最大横径<0.5 cm的息肉2 573枚(66.8%),0.5 cm以上的516枚(13.4%),1.0 cm以上的409枚(10.6%),2.0 cm以上的353枚(9.2%)。73枚(1.9%)息肉因机械性切割发生术中短暂的少量出血,56枚(76.7%)以圈套器高频电凝或热活检钳钳夹止血,17枚(23.3%)经喷洒1∶10000去甲肾上腺素盐水止血,均获成功。未发生穿孔及其他明显并发症。24枚(0.6%)未被切除的息肉的最大横径均>2.5 cm,占2.0 cm以上息肉的6.8%。结论结肠镜下高频电配以不同的治疗附件和黏膜下注射技术切除各种结肠息肉是安全可行的。更多还原

【Abstract】 ObjectiveTo study the feasibility of electronic colonoscopic polypectomy with high frequency electric using different techniques and equipments.MethodsThis study was carried out in 1 500 patients with colonic polyps(n=3 875) who underwent colonoscopic resection combined either with hot forceps,snare or snare after submucosal injection.ResultsA total of 3 851 polyps(99.4%) were resected,in which,adenomatous polyp accounted for 2 360(61.3%).The techniques used for the resections were: hot forcep(2 447,63.5%),snare(1 274,33.1%),or snare after submucosal injection(38,1.0%),snare in piecemeal(47,1.2%),snare after electric coagulation(45,1.2%).Morphologically,2 627(68.2%) were sessile;582(15.1%)flat;and 642(16.7%) with a long pedicle.Polyp diameter: less than 0.5 cm in 2573(66.8%);greater than 0.5 cm in 516(13.4%),greater than 1.0 cm in 409(10.6%) and greater than 2.0 cm in 353(9.2%).Bleeding occured in 73 polyps(1.9%) during the procedures,hemostasis was achieved by electric coagulation,or hot forceps or snare(56,76.7%),and by spraying of 1∶10 000 nonepinephrine(17,23.3%).No perforation or other complications were encountered.Polyps with diameter greater than 2.5 cm(24,0.6%) were failed to be resected.ConclusionThe colonoscopic polypectomy with high frequency electric is safe and feasible by the tecniques applied in this report.更多还原