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[目的]观察内镜下治疗胃肠大息肉的疗效。[方法]48例胃肠大息肉患者,息肉直径2.1～3.0cm28例,3.1～4.0cm15例,>4.0cm5例。病理组织学检查示管状腺瘤10例,绒毛状腺瘤11例,绒毛管状腺瘤17例,增生性息肉5例,息肉恶变5例。息肉有蒂者行高频电圈套切除;扁平者采取黏膜下注水后分片或分次切除。[结果]治疗成功率93.7%,8例术后即刻出血,1例术后24h出血,均予止血治疗,无一例发生穿孔。随访48例,4例息肉恶变患者随访超过3年,无复发;3例绒毛状腺瘤局部复发,2例再行局部微波或氩气刀治疗,1例建议外科手术治疗;余41例随访超过6个月,9例于其他部位发现新生息肉。[结论]内镜下治疗胃肠大息肉的方法安全、有效、可靠。
[Objective] To observe the efficacy of endoscopic treatment of gastrointestinal polyps. [Method] Among 48 cases of gastrointestinal polyps, 28 cases were 2.1-3.0 cm in diameter, 15 cases were 3.1-4.0 cm in diameter, and 5 cases were> 4.0 cm in diameter. Histopathological examination showed 10 cases of tubular adenoma, villous adenoma in 11 cases, 17 cases of villous tubular adenoma, 5 cases of proliferative polyps, 5 cases of malignant polyps. Polyp pedicled line high frequency electrosurgical excision; flat those who take submucosal watering after slicing or graded resection. [Results] The success rate of treatment was 93.7%, 8 cases were hemorrhage immediately after operation and 1 case was hemorrhage after operation. All cases were treated with hemostasis. No case of perforation occurred. Follow up of 48 cases, 4 cases of polypoid malignancies were followed up for more than 3 years, no recurrence; 3 cases of villous adenoma recurrence, 2 cases of local microwave or argon knife treatment, 1 case recommended surgical treatment; more than 41 cases were followed up 6 months, 9 cases found in other parts of new polyps. [Conclusion] The endoscopic treatment of gastrointestinal polyps is safe, effective and reliable.