Application of a new type of metal clip hemostat in bleeding under endoscopic colonic polypectomy
10.3760/cma.j.issn.1008-6706.2019.11.002
- VernacularTitle: 新型金属止血夹用于内镜下结肠息肉电切术中出血的治疗效果观察
- Author:
Weiqin ZHU
1
;
Huaming LI
Author Information
1. Department of Digestive Medicine, the Third People's Hospital of Hangzhou, Hangzhou, Zhejiang 310009, China
- Publication Type:Journal Article
- Keywords:
Colonic polyps;
Colonoscopy;
Endoscopic mucosal resection;
Bleeding;
Metal clips;
Hemostasis
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(11):1285-1288
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effect of a new type of metal clip hemostat in bleeding under endoscopic colonic polypectomy.
Methods:From January 2016 to December 2017, 298 cases of colonic polypectomy hemorrhage patients in the Third People's Hospital of Hangzhou were studied, and they were randomly divided into study group (149 cases) and control group (149 cases) according to the digital table.The control group was given general hemostat and hemostatics, and the study group was given new metal clips and hemostatic drugs under endoscopy.The hemostasis rate, the prognosis in the near and long term and the score of the severity of clinical symptoms at different treatment time points (T0-before treatment, T1-12h after treatment, T2-24h after treatment and T3-48h after treatment) were compared and analyzed in the two groups.
Results:The immediate hemostasis rate (86.58%), effective hemostasis rate (73.15%) and complete hemostasis rate (66.44%) in the control group were significantly lower than those in the study group (100.00%, 93.29% and 89.93%), and there were statistically significant differences in bleeding rates between the two groups (χ2=21.439, 21.629, 24.104, all P<0.05). The fecal occult blood clearance time [(3.54±0.18)d], bowel sound recovery time [(5.21±0.45)d] and hospitalization time [(8.42±0.75)d] of the study group were significantly shorter than those of the control group [(4.16±0.27)d, (7.18±0.26)d and (9.65±1.27)d], the differences were statistically significant between the two groups(t=23.322, 46.270, 10.180, all P<0.05). The rebleeding rate[(6.71%)(10/149)], complication rate[(3.36%)(5/149)] and mortality[(0.00%)(0/149)] in the study group were all lower than those in the control group [26.85%(40/149), 8.05%(12/149), 6.71%(10/149), 2.01%(4/149)], the differences were statistically significant between the two groups (χ2=21.629, 3.057, 1.755, 3.031, all P<0.05). The difference of clinical symptom severity score of the two groups at T0 was not obvious (P>0.05). The scores of clinical symptoms of the two groups at T1, T2 and T3 were decreased in turn, and the scores in the study group were all lower than those in the control group(t=77.562, 54.816, all P<0.05).
Conclusion:After bleeding in patients with colonic polyp electrotomy, the hemostatic rate of the new metal clip after endoscopic hemostasis is significantly improved, the curative effect is stable, the recurrence rate of bleeding is low, and the clinical application value is high.
