息肉电凝切除术后综合征回顾分析.docVIP

息肉电凝切除术后综合征回顾分析 息肉电凝切除术后综合征回顾分析 成都市第三人民医院消化科 邮编 610031 袁德强 史维 孙晓滨 吴立平 农春燕 奚维东 背景介绍:息肉电凝切除术后综合征(Postpolypectomy coagulation syndrome)为临床少见并发症，国外文献报道其发生率约0.51-- 1.2%[1,2] ，易误诊为肠穿孔，经保守治疗可完全痊愈，该并发症国内外报道不多，我们总结了近5年来我院2236例行肠道息肉电凝切除术病员，其中发生息肉电凝切除术后综合征7例，分析其相关因素，并探讨预防并发症的方法。 [摘要] 目的：分析息肉电凝切除术后综合征(Postpolypectomy coagulation syndrome)的临床特点及治疗对策。方法：回顾分析我院2000年1月-2005年12月行肠道息肉电凝切除术病人2236例，其中发生息肉电凝切除术后综合征7例，分析其临床资料,治疗过程,并发症相关因素。结果：本组中息肉电凝切除术后综合征发生率为0.31%，共7例，临床特征为术后出现局限性腹痛，腹部肌紧张，反跳痛等局部腹膜炎体征，部分患者出现发热、白细胞升高。全部病人均经禁食、补液、抗感染，卧床休息1-2天后症状完全缓解。7例患者息肉类型,大小,电凝时间等因素各不相同,多数通电时间较长。结论：息肉电凝切除术后综合征为少见并发症，易误诊为肠穿孔，经保守治疗可完全痊愈，应避免不必要的外科手术，病变的发生与多种因素有关，切除息肉时选择适当电流强度及通电时间，注意手术技巧等可能避免并发症的发生。 [关键词] 结肠息肉；息肉电凝切除术后综合征； Retrospective analysis of postpolypectomy coagulation syndrome De-Qiang Yuan, Wei Shi,Xiao-bin Sun, Li-Ping Wu, Chun-Yan Nong, Wei-Dong Xi. Department of Gastroenterology, Third Municipal Hospital Of Chengdu, Chengdu 610031,China [Abstract] Aims: To analyze the clinical characteristics and treatment strategy of postpolypectomy coagulation syndrome. Methods: 2236 patients who received colonic polypectomy from January 2000 to December 2005 were retrospectively analyzed,7 patients were dignosed with postpolypectomy coagulation syndrome among these patients, the clinical data, treatment procedure and complication correlated factors were analyzed respectively. Results: the incidence rate of postpolypectomy coagulation syndrome is 0.31% in our research group, clinical features are localized abdominal pain, tenderness and sometimes guarding, fever and leukocytosis can be seen in some patients, all symptoms disappeared after1-2 days treatment of bedrest, nothing by mouth, intravenous antibiotics and fluid transfusion. The variance in the terms of polypus type, size, duration of application are different , most of the duration are longer in those 7 patients. Conclusion: postpolypectomy coagulation syndrome is a rare complication, sometimes it can be misdiag