摘要
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 The study was attempted to observe the colorectal injury due to endoscopic snare polypectomy. Methods Histopathological study was conducted on 47 snared colorectal polyps as well as on the corresponding sites in 34 patients who underwent surgery thereafter for malignancy. Results The injury to all snared specimens was confined within submucosa,while that to surgically resected specimens at the snared sites extended to muscular and serosal layers in 28 out of 34 cases, which manifested as focal necrosis in inner muscularis and hemorrhage between inner and outer muscle layers, bearing no continuity with submucosal change.The mean size of polyps snared with injury to muscularis and serosa at the site was larger than those without ( P< 0.05). Conclusion The asymptomatic electrothermal injury following snare polypectomy is frequent. The occurrence depends on the largeness of polyp especially when it is >10mm.
出处
《中华消化内镜杂志》
2000年第6期327-329,T001,共4页
Chinese Journal of Digestive Endoscopy
关键词
大肠
高频电切术
电热损伤
Colorectum
Endoscopic polypectomy
Electrothermal injury
