江毓妮?陈钦明?余练?陈海彬

[摘要] 目的 探究內镜下胃肠道息肉高频电切术中预先放置金属钛夹的配合与效果。 方法 抽取来我院就医的100例胃肠道息肉患者（2013年4月～2016年4月）作为此次实验的目标对象，100例患者均实施内镜下高频电切术治疗，结合金属钛夹放置时机的不同将100例患者分两组，其中56例患者术中预先放置金属钛夹（实验组），44例患者待切除息肉后再放置金属钛夹（对照组），研究对比两组胃肠道息肉患者的手术时间、创面愈合时间、住院时间、并发症发生率以及钛夹的使用数量。 结果 实验组胃肠道息肉患者的手术时间显著短于对照组（P<0.05）；对于直径≥2cm胃肠道息肉患者，实验组患者钛夹使用数量显著少于对照组患者（P<0.05），但对于直径<2cm胃肠道息肉患者，实验组患者钛夹使用数量和对照组患者无显著差别（P>0.05）；对照组44例患者的并发症发生率为25.00%，显著高于实验组（5.36%）（P<0.05）；实验组胃肠道息肉患者的创面愈合时间、住院时间相比对照组明显更低（P<0.05）。 结论 在对胃肠道息肉患者实施内镜下高频电切术过程中，预先放置金属钛夹可有效减少并发症的发生，缩短手术时间，减少钛夹的使用数量，缩短创面愈合时间、住院时间。

[关键词] 内镜；胃肠道息肉；高频电切术；金属钛夹

[中图分类号] R735 [文献标识码] A [文章编号] 2095-0616（2017）07-230-04

Effect analysis of pre placed titanium clip in high - frequency electrosurgical excision of endoscopic gastrointestinal polyps

JIANG Yuni CHEN Qinming YU Lian CHEN Haibin

Digestive Endoscopy Center， Puning People's Hospital， Puning 515300， China

[Abstract] Objective To study the coordination and effect of pre placed titanium clip in high frequency resection of gastrointestinal polyps under endoscopy. Methods 100 patients with gastrointestinal polyps （April 2013 to April 2016） were enrolled in this study. All the 100 patients were given endoscopic high frequency resection combined with metallic titanium. The patients were divided into two groups according to the timing of the placement. Among them， 56 patients were placed with metal titanium clip （experimental group） and 44 patients were treated with metal titanium clip （control group）. The surgery time， wound healing time， length of stay， the incidence of complications and the use of titanium folder number of gastrointestinal polyps patients were studied and compared. Results The operation time in the experimental group was significantly shorter than that in the control group （P<0.05）. For the patients with diameter ≥2cm gastrointestinal polyps， the number of titanium clamps in the experimental group was significantly lower than that in the control group （P<0.05）. For the patients with diameter<2cm gastrointestinal polyps， the number of titanium clamps used in the experimental group was not significantly different from that in the control group （P>0.05）. The complication rate was 44.00% in the control group， which was significantly higher than that in the experimental group （5.36 %）， P<0.05. The wound healing time and hospitalization time of the patients in the experimental group were significantly lower than those in the control group （P<0.05）. Conclusion In the process of high frequency resection of gastrointestinal polyps in patients with gastrointestinal polyps， the placement of metal titanium clip in advance can effectively reduce the occurrence of complications， shorten the operation time， reduce the number of titanium clip， andshorten the wound healing time and hospital time.

[Key words] Endoscopy； Gastrointestinal polyps； High frequency resection； Metal titanium clip

胃肠道息肉属于临床较常见的消化道疾病之一，亦是导致消化道出血的常见病因之一，主要包括胃息肉及肠道息肉，其中胃息肉主要是指胃黏膜表面有突起状乳头状组织生成，该疾病的临床症状不显著，常在胃镜检查、胃肠钡餐造影或其他手术操作时发现；肠道息肉主要是指肠道黏膜发生慢性炎症，从而引起局部黏膜增生肥厚，最终导致肠道黏膜发生隆起样病变，目前，临床结合Morson组织学分类法中制定的标准常将肠道息肉分为肿瘤性、错构瘤性、炎症性以及增生性息肉[1]，有研究证实[2-3]，该疾病若不及时治疗，长期以往易引起机体出现癌变，极大程度威胁了患者的生命安全，因此，及时对其实施有效治疗至关重要。……