圈套器冷切除术在胃小息肉治疗中的应用

黄兰 李艳艳 李江涛

【摘要】 目的：探究圈套器冷切除術在胃小息肉治疗中的应用。方法：回顾性分析2021年1月—2022年7月九江市第一人民医院收治的胃小息肉（直径5～9 mm带蒂或亚蒂息肉）患者的临床资料，从接受圈套器冷切除术治疗的患者中随机抽取30例纳入观察组，从接受常规高频电切除术治疗的患者中随机抽取30例纳入对照组。比较两组手术情况、并发症情况、标本回收率、治疗费用和回访术后3个月的复发情况，并比较术前和术后3个月时的胃肠道功能情况[血清胃泌素释放肽前体（ProGRP）、胃蛋白酶原Ⅰ（PGⅠ）]。结果：观察组的手术时长、切除完整率、并发症发生率、治疗费用和复发率均显著优于对照组，差异均有统计学意义（P<0.05）；两组术中出血率和标本回收率差异均无统计学意义（P>0.05）。术后3个月时，两组ProGRP和PGⅠ均较术前显著降低，且观察组均低于对照组，差异均有统计学意义（P<0.05）。结论：圈套器冷切除术能够明显缩短操作时间，提高胃小息肉切除完整率，降低术后迟发性出血及穿孔等并发症发生率，显著改善胃肠道功能，降低治疗费用，有效避免复发情况。

【关键词】 圈套器冷切除术 常规高频电切除术 胃小息肉

Application of Cold Snare Polypectomy in Treating Small Gastric Polyps/HUANG Lan， LI Yanyan， LI Jiangtao. //Medical Innovation of China， 2024， 21（07）： 0-044

[Abstract] Objective： To explore the application of cold snare polypectomy in the treatment of small gastric polyps. Method： A retrospective analysis was performed on clinical data of patients with small gastric polyps （5-9 mm in diameter with pedicle or sub-pedicle polyps） admitted to Jiujiang NO.1 People's Hospital from January 2021 to July 2022. A total of 30 patients who received cold snare polypectomy were randomly collected and included in the observation group， and 30 patients who underwent conventional high-frequency electroresection were randomly enrolled as the control group. The surgical conditions， complications， sample recovery rate， treatment cost and recurrence status at 3 months after return visit and gastrointestinal function status [serum pro-gastrin-releasing peptide （ProGRP）， pepsinogen Ⅰ （PGⅠ）] before surgery and at 3 months after surgery were compared between the two groups. Result： The operation time， complete resection rate， complication rate， treatment cost and recurrence rate of the observation group were significantly better than those of the control group， the differences were statistically significant （P<0.05）. There were no significant differences in intraoperative bleeding rate and specimen recovery rate between the two groups （P>0.05）. At 3 months after surgery， the levels of ProGRP and PGⅠ were significantly reduced in both groups compared with those before surgery， and the observation group were lower than those of the control group （P<0.05）. Conclusion： Cold snare polypectomy can significantly shorten the operation time， enhance the complete rate of small gastric polyp resection， reduce the incidence rates of complications such as postoperative delayed bleeding and perforation， significantly improve the gastrointestinal function， lower the treatment costs， and effectively avoid the recurrence status.

[Key words] Cold snare polypectomy Conventional high-frequency electroresection Small gastric polyps

First-author's address： Department of Gastroenterology， Jiujiang NO.1 People's Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2024.07.010

胃息肉是一种具有恶变潜能的胃黏膜局部隆起性病变，其发病率为1.0%～6.4%，且近10年间发病率呈上升趋势[1]。得益于内镜技术的发展、内镜普查意识的普及、检查适应证的转变等，早期胃息肉的发现率不断升高[2]。虽然胃息肉是一种在胃内形成肿块的良性病变，但可进展成癌前病变，甚至胃癌的可能，其中腺瘤性息肉是癌变率最高的息肉，严重威胁着人类的健康[3]。炎症性息肉及增生性息肉通常认为恶变倾向小，但相关研究提示增生性息肉也可进展为腺癌[4]，故临床上建议及时切除。目前临床上，直径5～9 mm胃息……