無痛電子腸鏡下內鏡黏膜切除術聯合金屬鈦夾治療腸息肉的效果

竺添雨　孔弘偉　殷清華　蔣桂芳

【摘要】 目的：探討無痛電子腸鏡下內鏡黏膜切除術（endoscopic mucosal resection，EMR）聯合金屬鈦夾治療腸息肉的效果。方法：選取筆者所在醫院收治的80例腸息肉患者作為研究對象，按照手術方式分為對照組和觀察組，每組40例。對照組在普通腸鏡下行EMR術聯合金屬鈦夾治療，觀察組在無痛電子腸鏡下行EMR術聯合金屬鈦夾治療。比較兩組手術時間、術中出血量、術后并發癥及滿意度。結果：觀察組手術時間明顯短于對照組，術中出血量明顯少于對照組，差異均有統計學意義（P<0.05）;觀察組術后并發癥發生率顯著低于對照組，差異有統計學意義（P<0.05）;觀察組滿意度高于對照組，差異有統計學意義（P<0.05）。結論：無痛電子腸鏡下EMR術聯合金屬鈦夾治療腸息肉具有手術時間短、出血少、并發癥少、患者滿意度高的優勢，臨床效果顯著，值得推廣。

【關鍵詞】 腸息肉 無痛電子腸鏡 內鏡黏膜切除 金屬鈦夾 療效

doi：10.14033/j.cnki.cfmr.2020.16.059 文獻標識碼 B 文章編號 1674-6805（2020）16-0-03

Efficacy of Painless Electronic Colonoscopy with Endoscopic Mucosal Resection Combined with Metal Titanium Clips for Intestinal Polyps/ZHU Tianyu， KONG Hongwei， YIN Qinghua， JIANG Guifang. //Chinese and Foreign Medical Research， 2020， 18（16）： -146

[Abstract] Objective： To investigate the effect of painless electronic colonoscopy with endoscopic mucosal resection （EMR） combined with metal titanium clips in the treatment of intestinal polyps. Method： A total of 80 cases of intestinal polyps treated in our hospital were selected as the research object. The patients were divided into the control group and the observation group according to different surgical methods， 40 cases in each group. The control group was given ordinary enteroscopy with EMR combined with metal titanium clips. The observation group was given painless electronic enteroscopy with EMR combined with metal titanium clips. The operation time， intraoperative blood loss， postoperative complications and satisfaction were compared between the two groups. Result： The operation time of the observation group was significantly shorter than that of the control group， and the intraoperative blood loss was significantly less than that of the control group， and the differences were statistically significant （P<0.05）. The incidence of postoperative complications in the observation group was significantly lower than that of the control group， and the difference was statistically significant （P<0.05）. The satisfaction in the observation group was higher than that of the control group， and the difference was statistically significant （P<0.05）. Conclusion： Painless electronic colonoscopy with EMR combined with metal titanium clips for the treatment of intestinal polyps has the advantages of short operation time， less bleeding， fewer complications and high patients satisfaction. The clinical effect is significant and worthy of promotion.

[Key words] Intestinal polyps Painless electronic colonoscopy Endoscopic mucosal resection Metal titanium clip Efficacy

隨著麻醉技術的發展和提升，普通腸鏡下治療已不能滿足臨床和患者的需求。采用普通腸鏡治療，可使患者產生恐懼及緊張等情緒，造成不必要的痛苦和不適，導致配合度不佳，使手術時間延長及手術難度增加，特別是對于位置比較特殊的息肉，操作難度更大。研究表明，無痛腸鏡下EMR術聯合金屬鈦夾治療安全性更確切，可減輕患者痛苦，減少腸管牽拉所致的反射性痙攣，降低腸道出血、穿孔等嚴重并發癥風險，從而保證手術順利進行，并顯著提高患者滿意度[10-12]。研究結果示，觀察組手術時間、術中出血量、并發癥發生率、滿意度均顯著優于對照組（P<0.05），提示無痛電子腸鏡下EMR術聯合金屬鈦夾治療腸息肉效果優于普通電子腸鏡下EMR術聯合金屬鈦夾。

綜上所述，無痛電子腸鏡下EMR術聯合金屬鈦夾治療腸息肉的臨床效果顯著，安全可靠，值得在臨床中推廣。

參考文獻

[1]房玉海.結腸息肉發病相關危……