无痛内镜下黏膜切除术治疗结肠无蒂息肉52例疗效观察.docVIP

无痛内镜下黏膜切除术治疗结肠无蒂息肉52例疗效观察【摘要】 目的 探讨无痛内镜下黏膜切除术治疗结肠无蒂息肉的临床效果及并发症进行探讨。方法 对52例结肠无蒂息肉在芬太尼、丙泊酚静脉麻醉下行内镜下黏膜切除术，对切除标本进行病理组织学观察，术后定期内镜随访一年，以评价切除效果，记录术中术后发生并发症及处理情况。结果 52例患者81颗息肉均一次性切除成功率100%，1年后复查2例复发。总有效率为96.15%，复发率为3.85%，出血1例给予氩气凝固术（APC）治疗及药物喷洒治疗成功止血，未发现穿孔及其他并发症。结论 无痛内镜下黏膜切除术是一种安全微创的治疗手段，具有成功率高，操作简单、安全、无痛苦，损伤小等特点，值得临床推广和应用。 【关键词】 无痛;内镜下黏膜切除术;结肠息肉 a Research on the efficacy of treating 52 cases of colon sessile polyps with mucosal resection by painless endoscopy ZHAO Rui-bin， MIAO Lin.Tiankang Hospital of Tianchang city,Tianchang 239300,China 【Abstract】 Objective To investigate the efficacy and the complication of treating colon sessile polyps with mucosal resection by painless endoscopy. Methods Given 52 cases of colon sessile polyps endoscopic mucosal resection with the Fentanyl,Propofol anesthesia.Treated the resection specimens with histopathological observation and examined them with endoscopy regularly during following year after surgery. Recorded intraoperative and postoperative complications and the treatments. Evaluated the efficacy of resection. Results 81 colon sessile polyps of the 52 patients were resected once and for all with a success rate of 100%. Two recurrences were examined in a year. The total effective rate was 96.15%, the recurrence rate was 3.85%. Treat the only hemorrhage case with argon coagulation （APC） drug therapy and stop bleeding successfully. No perforation and other complications were examined. Conclusion Painless endoscopic mucosal resection is a safe and minimally invasive treatment characterized with high success rates, simplicity, safety, painlessness, less damage etc. This method is worthy of clinical application widely. 【Key words】 Painless endoscopy; Endos copic mucosal resection；Colon polyps 作者单位：239300 安徽省天长市天康医院（赵瑞斌）；南京医科大学第二附属医院消化科（缪林） 内镜下黏膜切除术（endoscopic mucosal resection EMR）自问世以来以逐渐发展成为一项成熟的内镜诊断与治疗技术。EMR不仅可获得较大标本进行病理学定性以提高诊断正确率而且还可作为一项治疗手段。作为一项微创内镜技术，EMR操作方法简便、创伤性小，并发症少，疗效可靠，具有广阔的临床应用前景。安徽省天长市天康医院自2009年5月至2010年