Folwaczny C, Heldwein W, Obermaier G, Schindlbeck N
Dept. of Gastroenterology, Ludwig Maximilians University, Munich, Germany.
Endoscopy. 1997 Jan;29(1):31-3. doi: 10.1055/s-2007-1004058.
Data concerning the potential benefit of local application of vasoconstricting substances prior to snare excision of colonic polyps are scarce. The influence of prophylactic submucosal injection of epinephrine in the prevention of hemorrhage after polypectomy was therefore evaluated in larger polyps.
Seventy-three patients, in whom 77 polyps more than 15 mm in diameter had been excised during a 30-month period, were included in this retrospective analysis. Twenty-eight polyps were excised with prophylactic injection of epinephrine into the polyp base, and 49 polyps were excised without the injection. All data were retrieved by reviewing the medical records.
No bleeding occurred in the epinephrine group (28 polyps). In contrast, nine of the 49 polypectomies that were carried out without prior administration of epinephrine were associated with a bleeding episode (P = 0.015).
Local injection therapy appears to reduce the risk of bleeding after the excision of larger polyps. Controlled trials are warranted in order to provide conclusive evidence concerning the prophylactic effect of epinephrine on hemorrhage after polypectomy.
关于在结肠息肉圈套切除术前局部应用血管收缩物质的潜在益处的数据很少。因此，我们评估了预防性黏膜下注射肾上腺素对较大息肉切除术后出血的预防作用。
本回顾性分析纳入了73例患者，在30个月期间共切除了77个直径大于15mm的息肉。28个息肉在切除前向息肉基底部预防性注射了肾上腺素，49个息肉切除时未注射。所有数据均通过查阅病历获得。
肾上腺素组（28个息肉）未发生出血。相比之下，49例未预先注射肾上腺素的息肉切除术中，有9例出现出血事件（P = 0.015）。
局部注射治疗似乎可降低较大息肉切除术后的出血风险。有必要进行对照试验，以提供关于肾上腺素对息肉切除术后出血预防作用的确凿证据。
