内镜下橡皮圈套扎与高频电切除术治疗消化道息肉的临床对比

Clinical comparative study on endoscopic rubber trapping and high frequency electroresection for gastrointestinal polyps

目的:对比内镜下橡皮圈套扎与高频电切除术治疗消化道息肉的临床疗效。方法:选择2017年2月至2019年5月在我院接受治疗的消化道息肉患者94例,以随机数字表法分为对照组和观察组(n=47)。对照组患者行内镜下高频电切术,观察组患者行内镜下橡皮圈套扎进行治疗。观察术中、术后的一般情况并计算手术成功率;采用酶联免疫吸附法测定术前及术后1 h血清促肾上腺皮质激素(Adrenocorticotrophic hormone,ATCH)、皮质醇(Cortisol,Cor)及去甲肾上腺素(Norepinephrine,NE);同时术前及术后2 d通过视觉模拟评分法(Visual analog scale,VAS)进行疼痛评分。结果:观察组总有效率明显高于对照组(P<0.05);患者手术时间、住院时间、愈合时间、术后2 d VAS评分均明显低于对照组(P<0.05)。与术前相比,术后两组患者ATCH、Cor及NE水平均明显升高(P<0.05),其中对照组升高幅度更明显(P<0.05)。结论:内镜下橡皮圈套扎治疗消化道息肉相比高频电切术,可明显提高手术成功率,缩短手术时间、住院时间及愈合时间,降低疼痛程度,降低应激反应程度。

Objective:To compare the clinical effect of endoscopic rubber band ligation and high-frequency electroresection in the treatment of gastrointestinal polyps.Methods:Ninety-four patients with digestive tract polyps treated in our hospital from February 2017 to May 2019 were selected and divided into 2 groups by random number table(n=47).The patients in control group received endoscopic high-frequency resection and the patients in observation group received endoscopic rubber band ligation.The general situation and calculate the success rate of the operation during and after the operation were observed.The serum adrenocorticotrophic hormone(ATCH),Cortisol(Cor)and norepinephrine(NE)before and 1 hour after the operation were measured by enzyme-linked immunosorbent assay.The visual Scale(VAS)before and 2 days after the operation were evaluated.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05),and the operation time,hospitalization time,healing time and 2D VAS score of the patients were significantly lower than that of the control group(P<0.05).Compared with pre-surgery,the levels of ATCH,Cor and NE in the two groups increased significantly after surgery(P<0.05),and the increase in the control group was more significant(P<0.05).Conclusion:Compared with high frequency electrotomy,endoscopic rubber band ligation can significantly improve the success rate of the operation,shorten the operation time,hospitalization time and healing time,reduce the degree of pain and stress response.