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目的:评价结肠镜下高频电圈套器联合尼龙绳套扎和/或钛夹钳夹摘除大肠宽蒂、大息肉的疗效及安全性.方法:结肠镜下宽蒂息肉先予尼龙绳套扎其息肉根部,再予高频电圈套器凝切;大息肉(直径大于2.0cm者)先予钛夹2-3枚在息肉根部钳夹,然后再用高频电圈套器分块凝切.结果:结肠镜治疗大肠息肉788例、其中宽蒂、大息肉156例(宽蒂67例、大息肉89例),经予上述方法进行内镜下摘除,一次性切除息肉102枚(65.38%),分次切除54枚(34.62%),均获满意疗效,其中即刻出血2例(1.28%),立即给予内镜下血凝酶喷洒、电凝和/或钛夹,即时止血,无迟发出血.全部病例无1例穿孔.结论:经结肠镜高频电圈套器摘除消化系宽蒂、大息肉前给予尼龙绳套扎和/或钛夹钳夹息肉根部,明显减少了出血、穿孔等并发症,突破了以往内镜治疗息肉关于大小、宽蒂等禁区,避免了手术引起的创伤,安全可靠,值得推荐.
OBJECTIVE: To evaluate the efficacy and safety of high-frequency electrosurgical unit with nylon cord ligation and / or titanium clamp in the colonoscopy for the removal of large polyps and large polyps.Methods: The polyps roots, and then to the high-frequency electric snare coagulation; large polyps (diameter greater than 2.0cm) to the first 2-3 titanium clip in the polyps root clamp, and then use high-frequency electric snare block coagulation. Results: Colonoscopy for the treatment of 788 cases of colorectal polyps, including wide peduncles, polyps in 156 cases (67 cases of wide peduncles, polyps 89 cases) were subjected to endoscopic removal of the above methods, a total removal of polyps 102 (65.38% , 54 cases (34.62%) were removed in multiple stages. All patients were satisfied with the curative effect. Immediate bleeding was found in 2 cases (1.28%). Immediate endoscopic hemagglutination enzyme spraying, electrocoagulation and / or titanium clips, immediate hemostasis, Bleeding.All patients had no case of perforation.Conclusion: The high-frequency electrosurgical device by colonoscopy removal of digestive tract wide pedicle, large polyps before giving nylon rope ligation and / or titanium clamp the root of polyps, significantly reducing the bleeding, perforation, etc. Complications, breaking the previous endoscopic treatment of polyps on the size, wide pedicle restricted area, to avoid the trauma caused by surgery, safe and reliable, it is worth recommend.