临床内科杂志
臨床內科雜誌
림상내과잡지
JOURNAL OF CLINICAL INTERNAL MEDICINE
2015年
5期
335-336
,共2页
消化内镜%尼龙绳%钛夹%结肠巨大腺瘤
消化內鏡%尼龍繩%鈦夾%結腸巨大腺瘤
소화내경%니룡승%태협%결장거대선류
Endoscopy%Nylon rope%Titanium clips%Giant colorectal adenomatous polyp
目的评价内镜下尼龙绳及钛夹联合治疗结肠巨大腺瘤的临床疗效及安全性。方法选择2012年2月~2014年5月于我院肠镜检查发现的结肠巨大腺瘤患者为研究对象。入选标准为结肠镜发现巨大腺瘤,粗蒂,宽1.0 cm 以上,且愿意接受内镜下治疗和随访。采用内镜下尼龙绳及钛夹联合治疗结肠巨大腺瘤,并随访观察以消除不良反应,统计其发生率。结果入选患者共39例,结肠巨大腺瘤40枚,其中男28例,女11例;年龄19~81岁,平均年龄(55.0±8.4)岁;病灶头部直径1.0~5.0 cm,平均直径2.5 cm,2.0~2.9 cm 者19例。病灶位于乙状结肠24例。39例全部顺利切除,无切除失败患者,切除后组织活检结果为绒毛管状腺瘤伴低级别上皮内瘤变16例。随访24个月,所有患者的原套扎部位均未出现新生息肉或恶变。结论采用内镜下尼龙绳及钛夹联合治疗结肠巨大腺瘤具有良好的效果,避免了外科手术或者腹腔镜治疗,降低了内镜下直接电切除术存在的穿孔与出血等风险,值得临床推广应用。
目的評價內鏡下尼龍繩及鈦夾聯閤治療結腸巨大腺瘤的臨床療效及安全性。方法選擇2012年2月~2014年5月于我院腸鏡檢查髮現的結腸巨大腺瘤患者為研究對象。入選標準為結腸鏡髮現巨大腺瘤,粗蒂,寬1.0 cm 以上,且願意接受內鏡下治療和隨訪。採用內鏡下尼龍繩及鈦夾聯閤治療結腸巨大腺瘤,併隨訪觀察以消除不良反應,統計其髮生率。結果入選患者共39例,結腸巨大腺瘤40枚,其中男28例,女11例;年齡19~81歲,平均年齡(55.0±8.4)歲;病竈頭部直徑1.0~5.0 cm,平均直徑2.5 cm,2.0~2.9 cm 者19例。病竈位于乙狀結腸24例。39例全部順利切除,無切除失敗患者,切除後組織活檢結果為絨毛管狀腺瘤伴低級彆上皮內瘤變16例。隨訪24箇月,所有患者的原套扎部位均未齣現新生息肉或噁變。結論採用內鏡下尼龍繩及鈦夾聯閤治療結腸巨大腺瘤具有良好的效果,避免瞭外科手術或者腹腔鏡治療,降低瞭內鏡下直接電切除術存在的穿孔與齣血等風險,值得臨床推廣應用。
목적평개내경하니룡승급태협연합치료결장거대선류적림상료효급안전성。방법선택2012년2월~2014년5월우아원장경검사발현적결장거대선류환자위연구대상。입선표준위결장경발현거대선류,조체,관1.0 cm 이상,차원의접수내경하치료화수방。채용내경하니룡승급태협연합치료결장거대선류,병수방관찰이소제불량반응,통계기발생솔。결과입선환자공39례,결장거대선류40매,기중남28례,녀11례;년령19~81세,평균년령(55.0±8.4)세;병조두부직경1.0~5.0 cm,평균직경2.5 cm,2.0~2.9 cm 자19례。병조위우을상결장24례。39례전부순리절제,무절제실패환자,절제후조직활검결과위융모관상선류반저급별상피내류변16례。수방24개월,소유환자적원투찰부위균미출현신생식육혹악변。결론채용내경하니룡승급태협연합치료결장거대선류구유량호적효과,피면료외과수술혹자복강경치료,강저료내경하직접전절제술존재적천공여출혈등풍험,치득림상추엄응용。
Objective To evaluate clinical efficacy and safety of the treatment of endoscopic nylon rope combined titanium clips in giant colorectal adenomatous polyp.Methods Thirty-nine patients with giant colorectal adenomatous polyp(the width of the pedicles were more than 1.0 cm)diagnosed by colonoscopy in our hospital between Feb.2012 and May.2014 were recruited in our study.They received endoscopic therapy of endoscopic nylon rope combined titanium clips and were followed up including the incidence of adverse events.Results Thirty-nine cases[28 males and 11 females,aged 19-81 (55.0 ± 8.4)years]had 40 giant colorectal adenomatous polyps,the length of the lesions range from 1.0 to 5.0cm with the average value of 2.5 cm,and 19 cases had lesions with the lengh of 2.0-2.9 cm.24 cases had the lesions located in the sigmoid colon.All polyps were removed successfully.Biopsy results of 16 cases were tubulovillous adenoma with low grade intraepithelial neoplasia.No neogenesis or malignant polyps occured in the original sites of ligation with 24 months’following up.Conclusion The treatment of endoscopic nylon rope combined titanium clips in patients with giant colorectal adenomatous polyp are effective, avoiding receiving further surgery or laparoscopic operation,reducing the risks of perforation and bleeding by direct electroresection with endoscopy,and it is worthy of clinical application.