漆国华

【摘要】目的  探讨内镜下黏膜切除术（EMR）在治疗结直肠无蒂息肉中的临床效果及价值。方法  选取我院2020年1月-2020年12月进行内镜下手术治疗的结直肠无蒂息肉患者60例作为研究对象进行回顾性分析，随机将患者分为观察组与对照组，每组各30例。观察组患者予以EMR治疗，对照组患者予以高频电凝圈套切除术治疗。比较2组患者手术时间、完全切除率、并发症发生率及住院时间。结果  观察组的手术时间及住院时间均较对照组短，术中出血量少于对照组（P<0.05）;观察组的完全切除率显著高于对照组（P<0.05）;观察组的并发症发生率低于对照组（P<0.05）。结论  内镜下黏膜切除术（EMR）在治療结直肠无蒂息肉中的临床效果优于高频电凝圈套切除术，完全切除率更高，值得应用推广。

【关键词】结直肠无蒂息肉;内镜下黏膜切除术;热圈套切;完全切除率;并发症

[Abstract] Objective To explore the clinical effect and value of endoscopic mucosal resection （EMR） in the treatment of colorectal sessile polyps. Methods Sixty patients with colorectal sessile polyps who underwent endoscopic surgery in our hospital from January 2020 to December 2020 were selected for retrospective analysis， and were randomly divided into observation group and control group， with 30 cases in each group. Patients in observation group were treated with EMR， while patients in control group were treated with high frequency electrocoagulation snare resection. The operation time， complete resection rate， complication rate and hospitalization time were compared between the two groups. Results The operation time and hospitalization time of the observation group were shorter than those of the control group， and the amount of bleeding during operation was less than that of the control group （P < 0.05）. The complete resection rate of observation group was significantly higher than that of control group （P < 0.05）. The incidence of complications in the observation group was lower than that in the control group （P < 0.05）. Conclusion Endoscopic mucosal resection （EMR） is better than high-frequency electrocoagulation snare resection in the treatment of colorectal pedunculated polyps， and its complete resection rate is higher， which is worthy of application and popularization.

[Keywords] colorectal sessile polyps; Endoscopic mucosal resection; Hot coil cutting; Complete resection rate; complication

息肉通常是指突入中空脏器管腔的任何肿块，结直肠息肉是指发生在结直肠的肿块，根据其外形可分为无蒂息肉及带蒂息肉，无蒂息肉外形扁平，直接来源于黏膜层。结直肠息肉具有发展为结直肠癌的风险，其中无蒂息肉发生癌变的风险更高，因此需要对其进行积极治疗。近年来，随着内镜技术的不断成熟与快速发展，临床通过内镜下息肉切除术达到切除息肉，预防结直肠癌的目的，其中以内镜下黏膜切除术（EMR）及高频电凝圈套切除术最为常用 。基于此，本研究对EMR及高频电凝圈套切除术进行了比较分析，以探讨内镜下黏膜切除术（EMR）在治疗结直肠无蒂息肉中的临床效果及价值，详细内容阐述如下。……