内镜下氩离子凝固术治疗老年人大肠息肉

Endoscopic argon plasma coagulation in the treatment of elderly patients with colorectal polyps

摘要:

目的 探讨内镜下氩离子凝固术（APC）治疗老年人大肠息肉的安全性和有效性。方法 采用德国ERBE公司生产的APC（VIO 200D型）内镜专用氩气刀对电子肠镜检查发现的大肠息肉进行内镜下治疗。结果 258例老年患者共检出525枚息肉全部使用APC治愈, 根据息肉大小和形态, 使用APC灼除302枚（57.5%）, APC切除89枚（17%）, 黏膜下注射后APC切除134枚（25.5%）, 局部渗血者行APC电凝或钛夹止血。术后2例（0.8%）出现少量便血, 予药物治疗后出血停止, 无穿孔和大出血等严重并发症。结论 APC可作为老年人大肠息肉的首选治疗, 安全性高, 并发症少。

Abstract:

Objective To evaluate the safety and efficacy of endoscopic argon plasma coagulation (APC) in the treatment of elderly patients with colorectal polyps. Methods Colorectal polyps found in electronic enteroscopy were treated with argon plasma generated by ERBE APC (VIO 200D, ERBE Company, German) . Results A total of 525 polyps were detected in 258 elderly patients and all were cured by APC. According to the polyp size and morphology, 302 (57.5%) sessile flat polyps with diameter 0.2 cm to 0.5 cm were ablated with APC, 89 (17%) semi-pedunculated and pedunculated polyps were resected by high-frequency electrosection, and 134 sessile (25.5%) polyps with diameter 0.6 cm to 5.0 cm were resected after submucosal injection with epinephrine plus methylene blue normal saline on focal membrane. APC electric coagulation or titanium clip was employed when bleeding appeared in partial wounds. Minor bleeding occurred in two patients (0.8%) and was stopped after treated with hemostatic drugs; there were no serious complications such as perforations or bleeding requiring transfusion. Conclusion APC is a well tolerated and effective treatment for elderly patients with colorectal polyps.