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目的观察大肠壁高频电切术所致的组织学损伤，阐明其组织病理学特征，为临床防治并发症提供有价值的参考资料。方法采用组织病理学方法，观察 34例外科切除大肠标本上的 47处内镜高频电切术切除部位和内镜切除标本。结果 47处内镜切除部位的粘膜下层均有不同程度的病变， 28处 (59.6％ )可见肌层或浆膜层的电热损伤，常表现为内肌层肌组织坏死、内外肌层间出血或纤维化及浆膜损伤。病变大多是局灶性的，与粘膜下层的病变不连续，呈现“跳跃”式的分布内镜切除标本的深度仅限于粘膜下层以内。内镜切除部位有肌层或浆膜病变者，内镜切除标本的平均最大径大于没有肌层或浆膜病变者（ P< 0.05）。内镜切除标本最大径 <10mm时，也可见肌层或浆膜的损伤。结论内镜切除术引起的无症状的肠壁电热损伤并不少见，其出现与内镜切除标本的大小有关，内镜切除最大径 <10mm的组织也可导致电热损伤并可能引起肠壁全层坏死。
Objective To observe the histological damage induced by high frequency electrosurgical excision of the large intestine wall and elucidate its histopathological features and provide valuable reference for clinical prevention and treatment of complications. Methods Histopathological methods were used to observe the excision sites and endoscopic resections in 47 cases of surgically removed large intestine specimens. Results 47 cases of endoscopic resection sites of submucosa have varying degrees of lesions, 28 (59.6%) showed muscle or serosa layer of electric heat damage, often manifested as myometrial muscle tissue necrosis, internal and external muscular interosseous hemorrhage or Fibrosis and serosa damage. Lesions are mostly focal, and submucosal lesions are not continuous, showing a “jump” type of distribution Endoscopic resection of the depth of the specimen is limited to the submucosa. The patients with myometrial or serosal lesions underwent endoscopic resection and the average maximum diameter of endoscopic resections was larger than those without myometrial or serosal lesions (P <0.05). Endoscopic resection of the largest diameter <10mm, also visible muscle or serosa damage. Conclusion The asymptomatic intestinal electric injury caused by endoscopic resection is not uncommon. The appearance of endoscopic resection is related to the size of the endoscopic resection specimen. The tissue with the largest diameter of <10 mm under endoscopic resection may also cause electric heat damage and may cause full-thickness Necrosis.