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1、内镜黏膜下切除宽基息肉对宽基息肉治疗的应用价值陈丽芬河池市人民医院消化内科，广西河池，547000摘要：目的：探讨宽基息肉采用内镜黏膜下切除治疗的临床价值。方法：通过前瞻性的随机对照方法的原则，纳入我院2011年9月-2014年7月收治的确诊为大肠宽基息肉的患者共120例，158个息肉，行内镜下黏膜切除术，手术切除的病理组织送病理科检查，记录并发症和成功率，评价内镜下黏膜切除术的安全性及有效性。结果：120例病例的基底直径均在2cm以上，其中在2-3cm的有92例，＞3cm的有28例；119例病例均一次性完整的剥离，仅有1例患者转外科手术治疗，内镜下黏膜切除术的成功率达
2、99.17%；治疗时间平均为85min；出现出现即可出血6例，迟发性出血的有12例，经保守治疗后痊愈，并发穿孔的仅1例转外科治疗；病理检查管状－绒毛状腺瘤72例，管状腺瘤24例，绒毛状腺瘤24例；40例伴低级别的上皮内瘤变，32例伴高级别的上皮内瘤变；基底边缘的组织并无病变残留。术后对病例进行1年的随访观察，均无复发病例及残留病例。结论：内镜黏膜下切除治疗宽基息肉局部复发率低，是消化系统宽基息肉安全有效治疗方法，值得临床推广应用。关键词：宽基息肉；内镜黏膜切除术；内窥镜治疗；临床价值Removalofpolypswidebasevalueofbroad-basedend
3、oscopicsubmucosalpolypstreatmentChenLi-fenHechiCityPeople'sHospital,DepartmentofGastroenterology,Hechi,547,000Abstract:Objective:Toinvestigatethebroad-basedpolypendoscopicmucosalresectionusingclinicalvalue.Methods:aprospectiverandomizedcontrolledprinciplesmethods,intomyhospitalinSeptembe
4、r2011-July2014admittedpatientsdiagnosedwithcolorectalpolypswidetotal120cases,158polyps,endoscopicmucosalresection,Histopathologyresecteddeliverpathologyexamination,recordingofcomplicationsandsuccessrate,withintheevaluationofEMRsafetyandefficacyofsurgery.Result:Thebasediameterof120Caseswe
5、remorethan2cm,whichhas92cases2-3cm,>3cmof28cases;119casesoffull-timepatientswerestripped,onlyonepatienttransfersurgery,Endoscopicmucosalresectionofthesuccessrateof99.17%;theaveragetreatmenttimewas85min;6casesappeartooccurbleeding,delayedhemorrhagein12cases,afterconservativetreatment,surg
6、icaltreatmentisonlyonecasecomplicatedbyperforationofturn;tubularpathology-villusadenoma72cases,24casesoftubularadenoma,villousadenoma24cases;intraepithelialwith40casesoflowgradeintraepithelialneoplasia32caseswithahighlevelofepithelium;tissuesubstrateedgenoresidualdisease.Ofthecaseswerefo
7、llowedupafteroneyear,norecurrenceandresidualcases.Conclusions:Endoscopicmucosalresectiontreatmentoflocalrecurrencerateofpolypswidebase,thedigestivesystemwidepolypssafeeffectivetreatment,worthyofclinicalapplication.Keywords:Widepolyps;endoscopicmucosalresection;endoscopict
