CAJ | 학술논문

目的：探讨钛夹在内镜下治疗横结肠息肉的临床疗效，并对其术后并发症发生情况进行讨论。方法回顾性分析2007年12月至2012年12月，该院消化内科收治的直径在1．0 cm以上横结肠良性肿瘤，并符合内镜治疗指征47例患者，均采用内镜下胃黏膜切除术（EM R）治疗。分成EM R术前在肿瘤周边1．0 cm内、延横结肠大血管解剖分布方向上钛夹（上钛夹组）21例，EM R术前未上钛夹（未上钛夹组）26例。分析两组一次性完整切除情况及术中出血情况及术后7 d内出血情况。结果钛夹组均一次性切除肿瘤，未上钛夹组由于术中出血量大视野不清，3例未能一次性完整切除，两组比较差异有统计学意义（P＜0．05）；术中出血情况钛夹组平均出血量（20．0±5．6）m L ，未上钛夹组平均为（80．0±8．2）m L ，两组比较差异有统计学意义（ P＜0．01）；钛夹组术后7 d内未并发出血，未上钛夹组术后7 d内出血3例，两组比较差异有统计学意义（P＜0．05）。结论 EMR治疗横结肠良性肿瘤，术前在肿瘤周边、延血管分布方向上钛夹能明显提高EM R术的临床疗效，并明显减少术中、术后出血，值得临床推广。
목적：탐토태협재내경하치료횡결장식육적림상료효，병대기술후병발증발생정황진행토론。방법회고성분석2007년12월지2012년12월，해원소화내과수치적직경재1．0 cm이상횡결장량성종류，병부합내경치료지정47례환자，균채용내경하위점막절제술（EM R）치료。분성EM R술전재종류주변1．0 cm내、연횡결장대혈관해부분포방향상태협（상태협조）21례，EM R술전미상태협（미상태협조）26례。분석량조일차성완정절제정황급술중출혈정황급술후7 d내출혈정황。결과태협조균일차성절제종류，미상태협조유우술중출혈량대시야불청，3례미능일차성완정절제，량조비교차이유통계학의의（P＜0．05）；술중출혈정황태협조평균출혈량（20．0±5．6）m L ，미상태협조평균위（80．0±8．2）m L ，량조비교차이유통계학의의（ P＜0．01）；태협조술후7 d내미병발출혈，미상태협조술후7 d내출혈3례，량조비교차이유통계학의의（P＜0．05）。결론 EMR치료횡결장량성종류，술전재종류주변、연혈관분포방향상태협능명현제고EM R술적림상료효，병명현감소술중、술후출혈，치득림상추엄。
Objective To investigate the clinical efficacy of the titanium clip in endoscopic treatment of the transverse colon pol‐yps and discuss the incidence of postoperative complications .Methods A retrospective analysis of 47 patients with the diameter of the transverse colon polyps with the diameter of 1 .0 cm above for EMR treatment .47 patients divided into titanium clip group (EMR preoperative using the titanium clip in the tumor periphery 1 .0 cm extension and vascular anatomy distribution ,n=21) and no titanium clip group (EMR preoperative no using the titanium clip ,n=26) .Analysis one‐time complete resection ,intraoperative blood loss and the hemorrhage after 7 days of two groups .Results There were one‐time removal of the tumor in the titanium clip group ,and no one‐time removal of the tumor in the no titanium clip group due to the large blood loss with poor visibility ,three cases can not be a one‐time complete resection ,the two groups were significantly different (P< 0 .05);the average amount of bleeding (20 .0 ± 5 .6)mL in titanium clip group ,that was (80 .0 ± 8 .2)mL in the on titanium clip group ;compared with the two groups , there was statistically significant (P<0 .01) .There was not complication of hemorrhage after 7 days ,but three cases were that in no titanium clip group ,the difference was significant (P<0 .05) .Conclusion EMR preoperative use the titanium clip in the tumor periphery 1 .0 cm extension and vascular anatomy distribution in trement of benign tumor of the transverse colon ,which can signifi‐cantly improve the clinical efficacy of EM R technique ,and significantly reduced the intraoperative and postoperative bleeding occur‐rence ,thus it's worthy of promotion .