摘要】 目的 对比内镜下氩离子凝固术和高频电凝切除术治疗结肠息肉的疗效。方法 收集我院治疗的肠息肉患者186例(息肉322枚)，根据治疗方法不同随机分为高频电凝切除组93例(息肉168枚)，氩离子凝固组93例(息肉154枚)，术后随访2个月，比较两组穿孔、出血并发症比例和治愈率。结果 高频电凝切除组并发出血10例(10.8%)高于氩离子凝固组3例(3.2%)，P<0.05，且高频电凝切除组出现穿孔1例。高频电凝切除组治愈率为94.5%，低于氩离子凝固组为100%，P<0.05。结论 与传统高频电凝切除术相比，氩离子凝固术治疗结肠息肉出血并发症少，治愈率高，值得临床推广。
【关键词】 结肠息肉;氩离子凝固术;高频电凝切除术;电子结肠镜
Abstract: Objective To compare the clinical effects of endoscopic argon plasma coagulation and highfrequency electroblation in the treatment of colonic ployps. Methods Totally 186 patients with colonic ployps were randomly divided into highfrequency electroblation group (group A, 93 patients) and argon plasma coagulation group (group B, 93 patients). All patients were followed up for two months and the rates of complications and recovery of both groups were compared. Results More cases of hemorrhagy were observed in group A (10 cases) than in group B (3 cases)(P<0.05) and 1 case of enterobrosis occurred in group A. The recovery rate of group A (94.5%) was lower than that of group B (100%),P<0.05. Conclusion Treating colonic ployps by endoscopic argon plasma can reduce the complications and increase the recovery rate; therefore it is worth promoting in clinics.
Keywords: colonic polyps; argon plasma coagulation; highfrequency electroblation; electronic colonoscopy
大肠多发息肉并发症多，癌变率高，尤其是巨大的腺瘤性息肉，并随着年龄增长而有升高的趋势。既往研究表明，大多数结肠癌是由结肠瘤性息肉癌变而来，腺瘤性息肉癌变率高达2.9%～9.4%[1]。因此，及时发现、治疗结肠息肉对降低大肠癌发病率具有重要意义。传统的高频电凝切除和新开展的氩离子凝固术(argon plasma coagulation，APC)都是目前内镜下治疗息肉常用的手段，具有创伤小、住院时间短、费用低等特点[25]，但两者在结肠息肉治疗的疗效方面尚无对比研究。本研究拟通过比较两种方法术后并发症和治愈率来探讨这一问题。
1 资料与方法
1.1 临床资料
本组病例186例(息肉322枚)，其中男102例，女84例，年龄16～76岁，平均(40.32±15.31)岁。随机分为高频电凝切除组和氩离子凝固组进行治疗。
1.2 治疗方法
两组患者均按內镜治疗常规准备。高频电凝切除组：肠镜送至息肉部位，适当充气并调整好位置，直径小于0.5 cm的小息肉用热活检钳摘除，其余采用混合波电凝器套扎切除。广基息肉或蒂较长的息肉则采用1∶10 000去甲肾上腺素根部注射致隆起后再电凝套扎切除，较大息肉一次不能切除者分片切除。氩离子凝固组：设定高频电发生器功率25～40 W。送肠镜至息肉部位，充分换气，然后经内镜钳道插入氩离子凝固导管至病灶上方0.3～0.5 cm处，凝固治疗每次1～
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