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目的探讨溃疡性结肠炎患者肠粘膜增生性病变(假性息肉、不典型增生)经内镜治疗术后能否导致溃疡性结肠炎复发。方法选取2011年1月~2015年12月在我院消化内科确诊为溃疡性结肠炎且明确有肠粘膜增生性病变(假性息肉、不典型增生)的患者120例,将其随机分为观察组和对照组,观察组中<0.3 cm的炎性息肉及不典型增生性改变应用APC治疗(氩离子凝固术),>0.3 cm的假性息肉及不典型增生改变应用APC治疗或圈套器切除。对照组则不做内镜治疗,常规口服药物治疗。结果通过对两组患者治疗后1~12个月的随访,观察组12个月内的总复发率为42.7%,对照组12个月内的总复发率为25.0%,观察组复发率较对照组高,差异有统计学意义(P<0.05)。随访观察可以得知,性别、超敏C-反应蛋白与溃疡性结肠炎复发有一定相关性,差异有统计学意义(P<0.05);血沉、医源性肠上皮损伤(内镜治疗后引起)与溃疡性结肠炎复发没有明显相关性,差异无统计学意义(P>0.05)。结论溃疡性结肠炎患者肠粘膜增生性病变(假性息肉、不典型增生)经内镜治疗后导致溃疡性结肠炎复发较未经内镜治疗的溃疡性结肠炎的患者复发率明显增高。溃疡性结肠炎复发与医源性肠上皮损伤、CRP、血沉有统计学意义,即有相关性。
Objective To investigate whether ulcerative colitis can recur after endoscopic treatment of patients with ulcerative colitis with intestinal mucosal hyperplastic lesions (pseudo-polyps, dysplasia). Methods A total of 120 patients with ulcerative colitis and clear intestinal mucosal hyperplasia (pseudo-polyp, atypical hyperplasia) diagnosed in our hospital from January 2011 to December 2015 were selected and randomly divided into observation Group and control group, the observation group of <0.3 cm of inflammatory polyps and atypical hyperplasia changes using APC treatment (argon ionocoagulation),> 0.3 cm of pseudo polyps and atypical hyperplasia changes should be treated with APC or snare excision . The control group did not do endoscopic treatment, conventional oral medication. Results According to the follow-up of 1 to 12 months after treatment, the total recurrence rate in the observation group was 42.7% in 12 months and that in the control group was 25.0% in 12 months. The recurrence rate in the observation group was significantly higher than that in the control group Group height, the difference was statistically significant (P <0.05). Follow-up observation can be found, gender, high sensitivity C-reactive protein and ulcerative colitis relapse have some relevance, the difference was statistically significant (P <0.05); ESR, iatrogenic intestinal epithelial injury ) Had no significant correlation with the recurrence of ulcerative colitis, the difference was not statistically significant (P> 0.05). Conclusions The incidence of ulcerative colitis recurrence in patients with ulcerative colitis is significantly higher than that in patients without ulcerative colitis after endoscopic treatment of intestinal mucosa hyperplasia (pseudo polyp, atypical hyperplasia). Recurrence of ulcerative colitis and iatrogenic intestinal injury, CRP, erythrocyte sediment was statistically significant, that is related.