注水钳除与普通钳除治疗结直肠微小息肉的临床疗效对比研究

Comparison of the clinical efficacy between biopsy forceps polypectomy with submucosal injection and traditional biopsy forceps polypectomy for diminutive colorectal polyps

摘要:

目的 探讨注水钳除治疗结直肠微小息肉的临床应用价值。方法 前瞻性选取2021年5月至2022年5月福建医科大学附属泉州第一医院内窥镜室收治的结直肠微小息肉（长径≤5 mm）患者按治疗方案不同将患者分为注水钳除组和普通钳除组。分析各组息肉的位置、分型、长径、直视下完全钳除率、息肉钳除及退镜时间、病理、标本回收率、并发症发生率、治疗费用等。比较注水钳除与普通钳除结直肠微小息肉的治疗效果。结果 共292例患者纳入研究，注水钳除组146例（息肉258枚），普通钳除组146例（息肉252枚）。注水钳除组与普通钳除组相比，钳除结直肠微小息肉视野清晰，息肉完全钳除率高［100.0%（258/258）比90.1%（227/252），χ2=26.915，P=0.001］。注水钳除组相对普通钳除组，并发症发生率低（1/146比13/146，χ2=10.804，P=0.001），治疗费用低［（173.7±15.9）元比（184.0±53.8）元，Z=-2.777，P=0.005］。注水钳除组息肉钳除及退镜时间比普通钳除组稍长［10（9，11）min比9（9，11）min］，但差异无统计学意义（Z＝-0.528，P=0.597）。两组患者息肉位置、长径、大体分型、病理、标本回收率等，差异亦无统计学意义（P>0.05）。结论 注水钳除治疗结直肠微小息肉安全有效，相对于普通钳除，息肉完全钳除率高、费用低，并发症少，是临床治疗结直肠微小息肉的新方法。

Abstract:

Objective To explore the clinical efficacy of biopsy forceps polypectomy with submucosal injection for diminutive colorectal polyps. Methods The patients with diminutive colorectal polyps (long diameter≤5 mm in size) who received polypectomy in Quanzhou First Hospital Affiliated to Fujian Medical University from May 2021 to May 2022 were prospectively recruited and divided into the observation group (biopsy forceps polypectomy with submucosal injection) and the control group (traditional biopsy forceps polypectomy). The location, morphology, long diameter, the complete polypectomy rate under direct vision, the time of resection and endoscopy withdrawal, pathological results, specimen collection rate, the incidence of complications and endoscopic treatment cost were analyzed. The clinical efficacy of the two methods were compared. Results A total of 292 patients were included in the study, with 146 in the observation group and 146 in the control group. There were 258 polyps in the observation group and 252 polyps in the control group. The complete polypectomy rate was higher in the observation group than that in the control group [100.0% (258/258) VS 90.1% (227/252), χ2=26.915, P=0.001] with clear vision. The incidence of complications in the observation group was lower than that in the control group (1/146 VS 13/146, χ2=10.804, P=0.001) , along with the lower treatment cost (173.7±15.9 yuan VS 184.0±53.8 yuan, Z=-2.777, P=0.005). The resection time in the observation group was longer than that in the control group, but the difference was not statistically significant [10 (9,11) min VS 9 (9,11) min, Z=-0.528, P=0.597]. There was no significant difference in the polyp position, long diameter, morphology, pathological classification, or the specimen collection rate between the two groups (P>0.05). Conclusion Biopsy forceps polypectomy with submucosal injection is safe for diminutive colorectal polyps, and it demonstrates a higher complete polypectomy rate, lower complication rates, and reduced treatment costs compared with traditional biopsy forceps polypectomy. It is a new perspective for managing diminutive colorectal polyps.