经结肠镜高频电圈套器联合尼龙绳套扎术与高频电切术治疗宽蒂息肉的术后血清指标比较

Comparison of postoperative serum indexes of colorectal polyps treated by colonoscopy, high frequency snare combined with nylon cord ligation and high frequency electric resection

目的对比经结肠镜高频电圈套器联合尼龙绳套扎术与高频电切术治疗宽蒂息肉的术后血清指标。方法收集2012年7月-2016年5月在该院接受治疗的宽蒂息肉患者70例作为研究对象,回顾手术方式及实验室检查结果,入组患者被分为接受经结肠镜高频电圈套器联合尼龙绳套扎术治疗的观察组37例、接受高频电切术治疗的对照组33例。记录两组患者的出血相关指标;手术前、术后1 h检测血清应激激素、急性时相蛋白含量。结果观察组的术中出血量少于对照组,术后即刻血红蛋白含量高于对照组,术后早期出血、迟发性出血比例低于对照组(P<0.05);术后1 h,观察组血清应激激素皮质醇(Cor)、促肾上腺皮质激素(ACTH)、血管紧张素Ⅱ(ATⅡ)、去甲肾上腺素(NE)、C反应蛋白(CRP)、淀粉样蛋白A(SAA)和α1-抗胰蛋白酶(AAT)含量低于对照组(P<0.05)。结论经结肠镜高频电圈套器联合尼龙绳套扎术治疗宽蒂息肉,可减少术中及术后出血,减轻机体应激及炎症反应。

Objective To compare the serum index after colonoscopy high-frequency electric snare combined with nylon cord ligation and high-frequency electric resection in treating broad pedicle polyps. Methods 70 cases of broad pedicle polyps patients from July 2012 to May 2016 were chosen as research object. The operation methods and laboratory examination results of all the patients were reviewed. All patients were divided into observation group （n =？37） and control group （n =？33）. Patients in observation group were treated by colonoscopy high-frequency electric snare combined with nylon loop ligation, while patients in control group were treated by high-frequency electric resection only. The blood loss and related indexes of the two groups were recorded. Before and after operation, stress hormones and acute phase proteins in serum was determined. Results Intraoperative blood loss of observation group was less than that in control group, postoperative hemoglobin levels was higher than that in control group, postoperative early bleeding rate, postoperative delayed bleeding rate of observation group were lower than that in control group （P 〈 0.05）; 1 hour after surgery, Cor, ACTH, AT II, NE, CRP, SAA, AAT in serum were lower than those in control group （P 〈 0.05）. Conclusion Through colonoscopy high-frequency electric snare combined with nylon cord ligation can reduce bleeding during and after surgery, relieve stress and infammation.