188体育

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应用电子胃镜下高频电凝电切术治疗上消化道息肉116例的临床分析

发布日期:2019-4-2 14:05:03 admin

188体育【ZHAIYAO】MUDE:TANJIUYINGYONGDIANZIWEIJINGXIAGAOPINDIANNINGDIANQIESHUZHILIAOSHANGXIAOHUADAOXIROUDELINCHUANGXIAOGUO。FANGFA:DUIWOYUAN116LIYINGYONGDIANZIWEIJINGXIAGAOPINDIANNINGDIANQIESHUZHILIAOSHANGXIAOHUADAOXIROUHUANZHEDELINCHUANGZILIAOJINXINGHUIGUXINGFENXI。JIEGUO:①CHULEYOU4LIHUANZHEYINDUOFAXIROUERFEN2CIJINXINGLEQIECHUSHOUSHUWAI,QIYUHUANZHEJUNSHUNLIYICIXINGWANCHENGLESHOUSHU。

上消化道息肉是胃黏膜上皮细胞的一种增生性病变。由于此病存在一定比例的恶变可能,所以临床上多主张应用手术疗法对其进行治疗。近几年,随着消化系统内镜技术的快速发展,有很多医院都采用电子胃镜下上消化道息肉高频电凝电切术对上消化道息肉病进行治疗。为了探究应用电子胃镜下高频电凝电切术治疗上消化道息肉的临床效果,笔者特对我院116例应用电子胃镜下高频电凝电切术治疗上消化道息肉患者的临床资料进行回顾性分析,现将分析结果报告如下。

1ZILIAOYUFANGFA

1.1YIBANZILIAO

CICIYANJIUDEDUIXIANGWEIWOYUAN116LICAIYONGDIANZIWEIJINGXIAGAOPINDIANNINGDIANQIESHUJINXINGZHILIAODESHANGXIAOHUADAOXIROUHUANZHE。QIZHONG,NAN53LI,NV63LI;NIANLINGWEI30~70SUI,PINGJUNNIANLINGWEI49SUI;BINGSHIWEI1~20YUNIAN;YOUOUXUE、HEIBIANZHENGZHUANGDE2LI,YOUFUTONGZHENGZHUANGDE53LI,YOUFUZHANGZHENGZHUANGDE64LI,YOUEXIN、OUTUZHENGZHUANGDE28LI。CI116LIHUANZHEGONGFASHENGXIROU176MEI。

QIZHONG,ZHIJING≤0.5cmDEXIROU78MEI,ZHIJINGWEI0.5~1.00mDEXIROU16MEI,ZHIJINGWEI1.

188体育0~1.50mDEXIROU8MEI,ZHIJINGWEI1.5~2.0mDEXIROU4MEI;DANFAXIROU46MEI,DUOFAXIROU46MEI(DUOFAXIROUZUIDUODEYILIWEI15MEI);XIROUBINGLILEIXINGWEIGUANZHUANGXIANLIUDE93MEI、RUTOUZHUANGXIANLIUDE32MEI、YANXINGXIROUDE51MEI。

1.2ZHILIAOFANGFA

188体育1.2.1SHUQIANZHUNBEICI116LIHUANZHEZAISHUQIANJUNXUJINXINGWEIJING、KONGFUXINDIANTU、NINGXUEJIZHI、NINGXUEMEIYUANSHIJIAN、XUEXIAOBANJISHUDENGJIANCHA。DUIYUCUNZAIKONGJUXINLIDEHUANZHE,YISHENGKEWEIQIJIZHUATUOPIN(ZHUSHELIANGWEI:0.5~1.0mg)HUO654-2(ZHUSHELIANGWEI:10mg)。

1.2.2SHOUSHUCAOZUODIANZIWEIJINGXIAGAOPINDIANNINGDIANQIESHUDECAOZUOBUZHOUWEI:①ZHUHUANZHEBIAN

HUANTIWEI,SHIXIROUJINKENENGDAMIANJIDIYUZHOUWEIZUZHIJIECHU。②JIANGXUANHAODEQUANTAOQICONGHUOJIANKONGCHARU,BINGZHUZHUSHOUQINGQINGSHOULONGTAOQUAN(BUKEYONGLIGUOMENG,YIMIANSHIXIROUYINJIXIEXINGQIEXIAERFASHENGCHUXUE)。③DAIXIROUBIANCHENGANZISESHI,JIANGQUANTAOQIDEWAITAOGUANJINTIEZAIYAOQIEGEDEBUWEI,TONGSHIDIAOZHENGNEIJINGDEJULI,SHINEIJINGDINGDUANYUXIROUJIANDEJULIBAOCHIZAI2mYISHANG、TAOQUANSUOTAOXIROUDIBUJUGUANBIDEJULIBAOCHIZAI0.3kmZUOYOU。④DAKAIDIANYUANKAIGUAN,JIANGDIANJIJINSHUTOUJIECHUDAOXIROUBINGANZHAOXIROUDEDAXIAODIAOJIEDIANJIDEZHILIAOGONGLV。⑤JINXINGSHEPINZHILIAO。SHEPINZHILIAODEFANGSHIXUGENJUXIROUDEDAXIAOERDING。YIBANQINGKUANGXIA,CUDIHUOWUDIXIROUKEXUANYONGXIANDIANNINGHOUDIANQIEHUOHUNHEDIANLIUZHUJIANQIECHUDEFANGSHIJINXINGZHILIAO(DIANNINGZHISHUWEI3~4.5、DIANQIEZHISHUWEI2.5~4.5),ZHANGDIXIROUKEXUANYONGXIANDIANNINGHOUDIANQIEPEIHEFANFUJIANDUANDUOCITONGDIANHUOHUNHEDIANLIUJIANXIETONGDIAN(MEICITONGDIANDESHIJIANWEISHUMIAOZHONG)JINXINGZHILIAO。DUIYUZHIJINGDAYU2mDEWUDI、KUANJIDIXIROU,YISHENGXUZAIZHILIAOQIANYUQIGENBUZHUSHESHILIANGNONGDUWEI1:10000DEQUJIASHENSHANGXIANSUYANSHUI。DUIYUXIANGJUJIAOJINDEDUOFAXIROU,YISHENGKEFENDUOCIJINXINGZHILIAO,ZHIZHIXIROUQUANBUBEIQIECHU。

1.2.3SHUHOUCHULISHUHOU,CI116LIHUANZHEJUNXUFUYONGZHIZIBENGYIZHIJI(MEIRIZAOWANFANQIAN30FENZHONGKONGFUKOUFU40m g)、AMOXILIN(MEICIFU0.5g,MEIRIFU3CI)HEKELAMEISU(MEICIFU250mg,MEIRIFU2CI)1~2ZHOU。

2JIEGUO

2.1SHOUSHUWANCHENGQINGKUANGZAICI116LIHUANZHEZHONG,CHULEYOU4LIHUANZHEYINDUOFAXIROUERFEN2CIJINXINGLEQIECHUSHOUSHUWAI,QIYUHUANZHEJUNSHUNLIYICIXINGWANCHENGLESHOUSHU。

188体育2.2SHOUSHUBINGFAZHENGZAICI116LIHUANZHEZHONG,CHULEYOU2LIHUANZHEZHUSUSHUZHONGYOUSHAOZHUOGANWAI,QIYUHUANZHEJUNWEICHUXIANSHOUSHUBINGFAZHENG。

2.3FUFAQINGKUANGCI116LIHUANZHEZAISHUHOU1~3GEYUENEIJUNFUCHALEWEIJING,QIJIEGUOXIANSHI,XIROUQUANBUXIAOSHIQIEWEIJIANFUFA。

3TAOLUN

3.1GAOPINDIANNINGDIANQIESHUDEYUANLIGAOPINDIANNINGDIANQIESHUSHIYIZHONGJIEZHUSHEPINDIANLIUSHIFANGRENENGLAISHIXIROUSHIQUHUOXINGDEZHILIAOFANGFA。YOUYURENTIZUZHIDEDIANZUGUODA,SUOYIDANGSHEPINDIANLIUJINRURENTIZUZHIHOU,QISUOJUYOUDEDIANNENGJIUHUIJIHUQUANBUZHUANHUAWEIRENENG。DANGZHEIXIERENENGZUOYONGYUXIROUZUZHISHIJIUHUISHIXIROUZUZHIDEDANBAIFASHENGNINGGUBIANXING、XIBAOFASHENGYANZHONGTUOSHUI,CONGERSHIXIROUSHIQUHUOXING。

188体育3.2LINCHUANGTIHUITONGGUODUICI116LIHUANZHEDELINCHUANGZILIAOJINXINGFENXIHOU,BIZHERENWEI,ZAIYINGYONGDIANZIWEIJINGXIAGAOPINDIANNINGDIANQIESHUZHILIAOSHANGXIAOHUADAOXIROUSHI,YISHENGXUZHUYIYIXIAJIDIAN:①SHUQIANBIXUWEIHUANZHEJINXINGXINDIANTUHENINGXUEJIZHIJIANCHA,YIMIANFASHENGYANZHONGDESHUZHONGBINGFAZHENG(RUXINZANGZHOUTING、CHUANGKOUDACHUXUEDENG)。②SHUZHONGCAOZUOYIDINGYAOSHULIAN,YIBIANJIANGDIHUANZHEFASHENGSHUHOUGANRANDEJILV。③SHUHOUYIDINGYAOYAOQIUHUANZHEDINGQIJINXINGFUCHA。DINGQIFUCHASHIYUFANGSHANGXIAOHUADAOXIROUFASHENGAIBIANDEZUIYOUXIAOTUJING。

ZONGSHANGSUOSHU,YINGYONGDIANZIWEIJINGXIAGAOPINDIANNINGDIANQIESHOUSHUZHILIAOSHANGXIAOHUADAOXIROUJUYOULIAOXIAOXIANZHU、SUNSHANGXIAO、FEIYONGDIDENGYOUDIAN,SHIYIZHONGZHIDEZAILINCHUANGSHANGTUIGUANGHEYINGYONGDEZHILIAOSHANGXIAOHUADAOXIROUDEHAOFANGFA。