检索历史 清除

目的 评估钛夹及尼龙绳预防肠道较大息肉切除后出血的效果.方法 回顾性收集2003年1月至2016年3月行息肉切除的病例,息肉均＞10 mm.将病例分为4组,A组为粗蒂息肉切除前预先用钛夹夹闭的病例,B组为粗蒂息肉切除前预先用尼龙绳套扎的病例;C组为较大的平坦或隆起型非粗蒂息肉切除后用钛夹夹闭的病例,D组为较大的平坦或隆起型非粗蒂息肉切除后未用钛夹夹闭的病例.分析每组病例的术中、术后出血发生率及临床病理特征.在Pubmed数据库检索近五年的有关钛夹或尼龙绳预防息肉切除后出血的文献,总结分析其特征.结果 共2 006例息肉纳入分析,A组的术中出血率为3.4％ (5/147),迟发性出血率为6.1％ (9/147);B组的术中出血率为3.8％(5/132),迟发性出血率为7.6％(10/132);C组的迟发性出血率为3.2％(28/888);D组的迟发性出血率为1.9％(16/839).以上出血病例无需行外科手术,且无一例穿孔.在Pubmed数据库共检索出6篇有关钛夹或尼龙绳预防息肉切除后出血的文献,大多数研究提出,钛夹或尼龙绳是预防息肉切除后出血的有效的止血方式.结论 预先使用钛夹和尼龙绳是预防息肉切除后出血的有效止血措施;对于非粗蒂较大息肉(直径＞10 mm)切除后,钛夹也可用于预防术后出血,但其效果有待验证.

Objective To investigate the preventive effect of endoclips and endoloops on postpolypectomy bleeding of large colorectal polyps.Methods Data of patients,who underwent polypectomy during January 2013 to March 2016,were retrospectively collected.The diameters of all polyps were more than 10 mm.Cases were divided into 4 groups.Before large pedunculated (with thick stalks) polyps were resected,endoclips were used to ligate the pedicles of polyps in Group A,and endoloops were used in Group B.After large sessile and pedunculated (without thick stalks) polyps were resected,endoclips were used to close the incision of polypectomy in Group C,but not in Group D.The immediate and delayed postpolypectomy bleeding rate and clinicopathologic features were studied.Articles about endoclip or endoloop on preventing post-polypectomy bleeding in PubMed in last five years were searched and analyzed.Results A total of 2 006 polyps were included.The immediate bleeding rate was 3.4％ (5/147) and 3.8％ (5/132) of Group A and B,respectively.The delayed bleeding rate was 6.1％ (9/147) and 7.6％ (10/132) of Group A and B,respectively.The delayed bleeding rate of Group C and D was 3.2％ (28/888) and 1.9％ (16/839),respectively.None of the bleeding cases needed a surgical operation.And no perforation occurred.Six articles were included for analysis.Most of articles revealed that endoclip and endoloop were effective tools in prevention of post-polypectomy bleeding.Conclusion Endoclips and endoloops are useful to prevent bleeding after resection of large pedunculated (with thick stalks) polyps.For large sessile and pedunculated (without thick stalks) polyps (diameter＞ 10 mm),the effect of endoclips to prevent postpolypectomy bleeding still needs further discussion.