| 内镜下黏膜切除术治疗儿童结肠大息肉的应用研究 |
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| 引用本文： | 田琪,董亮,李金鑫,李苗苗,崔华雷.内镜下黏膜切除术治疗儿童结肠大息肉的应用研究[J].天津医科大学学报,2023,0(2):170-173. |
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| 作者姓名： | 田琪 董亮 李金鑫 李苗苗 崔华雷 |
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| 作者单位： | 天津市儿童医院微创外科，天津300074 |
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| 摘 要： | 目的:探讨内镜下黏膜切除术（EMR）治疗儿童结肠大息肉的临床应用价值。方法:回顾性分析天津市儿童医院行结肠镜下息肉切除术的结肠大息肉（息肉直径≥10mm）病例141例，其中行EMR的病例69例为观察组。行结肠镜下高频电凝电切除术的病例72例，设定为对照组，对比两组手术时间、并发症发生率及术后恢复时间及术后住院时间等，探讨不同手术方式治疗儿童结肠大息肉的手术效果和安全性。结果:两组患者年龄结构、性别组成及术前临床表现等多方面差异无明显统计学意义（均P>0.05）。与对照组相比，观察组手术时间长（27.44±2.61）minvs.（31.72±3.92）min]，两组间差异具有统计学意义（t=7.661，P＜0.05）。与对照组相比，观察组术后便潜血转阴时间（2.46±0.52）dvs.（1.72±0.41）d]、肠道恢复时间（2.47±0.35）dvs.（1.86±0.44）d]、术后住院时间（6.41±0.95）dvs.（5.21±0.86）d]更短，差异均具有统计学意义（均P＜0.05）。术后并发症情况比较，观察组出血5例（7.3%）、穿孔0例、息肉切除术后电凝综合征1例（1.5%），并发症总数6例（8.7%）；对照组出血12例（16.7%）、穿孔1例（1.4%）、息肉切除术后电凝综合征2例（2.8%），并发症总数15例（20.8%）。并发症总体发病率差异具有统计学意义（χ2=4.095，P＜0.05）。结论:与内镜下高频电凝电切除术相比，EMR在治疗儿童结肠大息肉的临床疗效及安全性方面具有明显的优势。
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| 关 键 词： | 结肠大息肉 儿童 手术方式 |
Application of endoscopic mucosal resection in the treatment of large colonic polyps in children |
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| TIAN Qi,DONG Liang,LI Jin-xin,LI Miao-miao,CUI Hua-lei.Application of endoscopic mucosal resection in the treatment of large colonic polyps in children[J].Journal of Tianjin Medical University,2023,0(2):170-173. |
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| Authors: | TIAN Qi DONG Liang LI Jin-xin LI Miao-miao CUI Hua-lei |
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| Affiliation: | Department of Minimally Envasive Surgery，Tianjin Children′s Hospital，Tianjin 300074，China |
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| Abstract: | Objective:To explore the clinical value of endoscopic mucosal resection（EMR）in the treatment of large colonic polyps in children. Methods:Retrospective analysis was made on 141 cases of large colon polyps（polyp diameter greater than or equal to 10 mm） who underwent colonoscopic polypectomy in Tianjin Children′s Hospital. Among them，69 cases underwent EMR as observation group， 72 cases of high frequency electrocoagulation resection under colonoscopy were set as reference group. The operation time，complication rate，postoperative recovery time and postoperative hospital stay of the two groups were compared to explore the effect and safety of different surgical methods in the treatment of large colonic polyps in children. Results:There was no significant difference in age structure，sex composition and preoperative clinical manifestations between the two groups（all P>0.05）. The operation time（min）was（31.72±3.92） in the observation group and（27.44±2.61）in the reference group. The difference between the two groups was statistically significant （t=7.661，P<0.05）. The time of stool occult blood turning negative after operation（days）was（1.72±0.41）in the observation group and （2.46 ± 0.52）in the reference group. Intestinal recovery time（days）was（1.86 ± 0.44）in the observation group and（2.47±0.35）in the reference group. Postoperative hospital stay（days）was（5.21±0.86）in the observation group and（6.41±0.95）in the reference group. The difference between the two groups was statistically significant（all P<0.05）. The postoperative complications of the two groups were compared. In the observation group，there were 5 cases of bleeding（7.3%），0 cases of perforation，1 case of electrocoagulation syndrome after polypectomy（1.5%），and the total number of complications was 6 cases（8.7%）. In the reference group，bleeding occurred in 12 cases（16.7%），perforation in 1 case（1.4%），and electrocoagulation syndrome after polypectomy in 2 cases（2.8%）. The total number of complications was 15 cases（20.8%）. The overall incidence rate of complications between the two groups was statistically significant（χ2=4.095，P＜0.05）.Conclusion:Compared with endoscopic high-frequency electrocoagulation，EMR has obvious advantages in clinical efficacy and safety in the treatment of large colonic polyps in children. |
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| Keywords: | children large polyps surgical methods |
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