Comparison of short-term curative effect and postoperative recurrence rate of patients with colon polyps by different surgical methods under endoscopy
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摘要: 目的 探讨内镜下3种术式[内镜下高频电切术、内镜下氩离子束凝固术、内镜下黏膜切除术(EMR)]治疗结肠息肉的有效性和安全性。方法 选取2017年5月—2019年5月杭州市萧山区第一人民医院收治的150例结肠息肉患者，按手术方式的不同分为A组、B组、C组，各50例。A组采用内镜下高频电切术，B组采用内镜下氩离子束凝固术，C组采用EMR，比较3组患者手术情况、临床疗效、并发症及随访情况。结果 B、C组手术时间、临床总有效率明显高于A组(P< 0.05)，且B、C组间比较差异无统计学意义(P>0.05)；3组间术后住院时间、平均息肉个数比较，差异无统计学意义(P>0.05)；B、C组不良反应发生率明显低于A组(P< 0.05)，B、C组间比较，差异无统计学意义(P>0.05)；3组随访时间、复发率比较，差异无统计学意义(P>0.05)。结论 相较于内镜下高频电切术，内镜下氩离子束凝固术、EMR治疗结肠息肉患者手术效果更佳，有效率及安全性更高。Abstract: Objective To explore the effectiveness and safety of three endoscopic procedures(endoscopic high-frequency resection, endoscopic argon ion beam coagulation, and endoscopic mucosal resection) for the treatment of colon polyps.Methods A total of 150 colon polyps patients admitted to our hospital from May 2017 to May 2019 were selected and divided into groups A, B, and C according to different surgical methods, with 50 cases in each group. Group A used endoscopic high-frequency resection, group B used endoscopic argon ion beam coagulation, and group C used endoscopic mucosal resection(EMR). The operation conditions, clinical efficacy, complications, and follow-up were compared among the three groups.Results The operation time, the total clinical effective rate of group B and group C were apparently higher in comparison with those of group A(P< 0.05), and there was no obvious divergence between group B and group C(P>0.05); there was no obvious divergence in postoperative hospital stay and the average number of polyps among the three groups(P>0.05); the incidence of adverse reactions in groups B and C was apparently lower in comparison with that of group A(P< 0.05), there was no obvious divergence between groups B and C(P>0.05); there was no obvious divergence in follow-up time and recurrence rate among the three groups(P>0.05).Conclusion In contrast to endoscopic high-frequency resection, endoscopic argon ion beam coagulation, and EMR have better surgical results for patients with colon polyps, with higher efficiency and safety.
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Key words:
- colon polyps /
- endoscopy /
- high-frequency resection /
- argon ion beam coagulation /
- mucosal resection
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表 1 3组患者一般资料比较
观察指标 A组(n=50) B组(n=50) C组(n=50) χ2/F P 性别/例 男 27 29 26 0.377 0.828 女 23 21 24 年龄/岁 49.82±8.54 49.71±8.65 48.89±8.34 0.178 0.837 病程/周 10.38±2.71 11.62±2.59 10.35±2.26 1.121 0.329 息肉数量/个 2.57±0.24 2.52±0.26 2.54±0.23 0.533 0.588 息肉位置/例 乙状结肠 33 35 35 升结肠 11 10 9 0.395 0.983 降结肠 6 5 6 息肉类型/例 炎性息肉 17 14 16 0.434 0.805 腺瘤性息肉 33 36 34 
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表 2 3组患者手术情况比较
X±S 组别 例数 手术时间/h 术后住院时间/d 平均息肉个数/枚 A组 50 1.02±0.34 5.41±1.39 2.59±0.34 B组 50 1.38±0.321) 5.36±1.37 2.54±0.26 C组 50 1.42±0.371) 5.34±1.33 2.26±0.35 F 5.689 0.035 0.004 P 0.004 0.966 0.996 与A组比较，1)P < 0.05。
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表 3 3组患者临床疗效比较
例(%) 组别 例数 治愈 显效 有效 无效 总有效 A组 50 13(26.00) 16(32.00) 10(20.00) 11(22.00) 39(78.00) B组 50 14(28.00) 21(42.00) 12(24.00) 3(6.00) 47(94.00)1) C组 50 16(32.00) 20(40.00) 12(24.00) 2(4.00) 48(96.00)1) χ2 10.215 P 0.006 与A组比较，1)P < 0.05。
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表 4 3组患者术后并发症情况比较
例(%) 组别 例数 穿孔 出血 不良反应发生情况 A组 50 0 5(10.00) 5(10.00) B组 50 0 0 01) C组 50 0 1(2.00) 1(2.00)1) χ2 7.292 P 0.026 与A组比较，1)P < 0.05。
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