内镜下结肠息肉冷切除对结肠息肉患者出血量及血清疼痛因子水平的影响研究

Effects of endoscopic cold resection of colon polyps on blood loss and serum pain factor levels in patients with colon polyps

目的探讨与研究内镜下结肠息肉冷切除对结肠息肉患者出血量及血清疼痛因子水平的影响。方法前瞻性选取2021年1月到2021年12月南京鼓楼医院集团宿迁医院收治的结肠息肉患者240例,采用随机数字表法将其均分为冷切除组与对照组。冷切除组给予内镜下圈套器冷切除术治疗,对照组给予内镜下黏膜切除术。记录患者围手术指标、并发症情况、疼痛视觉模拟评分法(VAS)评分,并检测血清疼痛因子[前列腺素E2(PGE2)、神经生长因子(NGF)]水平变化情况。结果两组手术时间、术后住院时间对比差异无统计学意义(P>0.05),冷切除组的术中出血量、息肉切除时间为(10.88±1.45)mL、(1.47±0.24)min,均少于对照组[(25.01±2.17)mL、(3.45±0.33)min],差异均有统计学意义(P<0.05)。两组术后3 d的穿孔与出血等并发症发生率比较,差异无统计学意义(P>0.05)。两组患者术后疼痛VAS评分均随时间显著减少,冷切除组术后1、2、3 d的疼痛VAS评分为(2.49±0.21)、(1.76±0.24)、(1.11±0.15)分,均低于对照组[(4.22±0.18)、(2.87±0.34)、(2.00±0.17)分],差异均有统计学意义(P<0.05)。两组术后3 d的PGE2、NGF水平低于术前1 d,冷切除组PGE2、NGF水平为(98.28±4.57)、(28.76±3.18)pg/mL,均低于对照组[(134.92±12.55)、(43.10±4.82)pg/mL],差异均有统计学意义(P<0.05)。结论内镜下结肠息肉冷切除在结肠息肉患者的应用能抑制血清PGE2与NGF的表达,促进缓解疼痛,能减少出血量与息肉切除时间,降低并发症的发生。

Objective To explore and study the effects of endoscopic cold excision of colon polyps on blood loss and serum pain factor levels in patients with colon polyps.Methods A total of 240 cases of patients with colon polyps who were diagnosed and treated in Suqian Hospital of Nanjing Drum Tower Hospital Group from January 2021 to December 2021 were prospectively selected as the research subjects,and were equally divided into the cold resection group and the control group by random number table method.The cold excision group was treated with endoscopic snare cold excision,and the control group was treated with endoscopic mucosal excision.The perioperative indicators,complications,pain visual analogue scale(VAS)score of the patients were recorded,and the changes of serum pain factor[prostaglandin E2(PGE2)and nerve growth factor(NGF)]levels were detected.Results There were no significant differences in operation time and postoperative hospital stay compared between the two groups(P>0.05).The intraoperative blood loss and polyp removal time in the cold resection group were(10.88±1.45)mL and(1.47±0.24)min,which were all less than those in the control group[(25.01±2.17)mL,(3.45±0.33)min],and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications such as perforation and bleeding between the two groups at 3 days after operation(P>0.05).The postoperative pain VAS scores of the two groups were significantly decreased over time,the VAS scores of the cold excision group at 1,2,and 3 days after the operation were(2.49±0.21)points,(1.76±0.24)points,and(1.11±0.15)points,which were lower than those in the control group[(4.22±0.18)points,(2.87±0.34)points,(2.00±0.17)points],the differences were statistically significant(P<0.05).The levels of PGE2 and NGF in the two groups at 3 days after operation were lower than those at 1 day before operation,the levels of PGE2 and NGF in the cold excision group were(98.28±4.57)pg/mL,(28.76±3.18)pg/mL,which were lower than those in the control group[(134.92±12.55)pg/mL,(43.10±4.82)pg/mL],the differences were statistically significant(P<0.05).Conclusion The application of endoscopic cold excision of colon polyps in patients with colon polyps can inhibit the expression of serum PGE2 and NGF,promote pain relief,reduce blood loss and polyp excision time,and reduce the occurrence of complications.