钛夹联合血凝酶在预防结肠病损术后迟发性出血的疗效观察

Clinical observation of titanium clip combined with hemocoagulase in preventing delayed bleeding after operation of colonic lesions

目的:分析钛夹联合血凝酶在预防结肠病损术后[内镜黏膜下剥离术(ESD)、内窥镜下黏膜切除术(EMR)]迟发性出血的效果。方法:选取2018年2月~2021年2月接受内镜黏膜下剥离术或内窥镜下黏膜切除术的60例结肠病患者,采用数字表法分为对照组和观察组各30例,给予对照组血凝酶注射治疗,观察组在对照组基础上联合钛夹治疗,观察两组血管内皮生长因子(VEGF)、表皮细胞生长因子(EGF)水平、迟发性出血发生率、术后恢复情况、并发症发生率。结果:治疗后两组VEGF、EGF水平均明显上升,差异有统计学意义(P<0.05);对照组与观察组VEGF、EGF水平差异无统计学意义(P>0.05)。观察组迟发性出血为16.67%明显低于对照组的40.00%,差异有统计学意义(P<0.05)。观察组肠蠕动恢复时间、进食时间、住院时间均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为13.33%明显低于对照组的36.67%,差异有统计学意义(P<0.05)。结论:结肠病损术患者应用钛夹联合血凝酶进行预防治疗,可在极大程度上降低迟发性出血情况,不仅能缩短患者术后康复进程,还能降低术后并发症的发生风险。

Objective To analyze the effect of titanium clip combined with hemocoagulase in the prevention of delayed bleeding after colon lesion surgery(endoscopic submucosal dissection, endoscopic mucosal resection).Method From February 2018 to February 2021, 60 patients with colon disease who underwent endoscopic submucosal dissection or endoscopic mucosal resection were selected and divided into control group(n=30) and observation group(n=30) by digital table method;The control group was treated with hemagglutinin injection, the observation group was treated with titanium clip on the basis of the control group. The levels of vascular endothelial growth factor(VEGF), epidermal growth factor(EGF), incidence of delayed hemorrhage, postoperative recovery and incidence of complications were observed.Results After treatment, the levels of VEGF and EGF in the two groups were significantly increased(P<0.05). There was no significant difference in the levels of VEGF and EGF between the control group and the observation group(P>0.05). The incidence of delayed hemorrhage in the observation group was 16.67%, which was significantly lower than 40.00% in the control group(P<0.05). The recovery time of intestinal peristalsis, eating time and hospitalization time of the observation group were lower than those of the control group(P<0.05). The incidence of complications in the observation group was 13.33%, which was significantly lower than 36.67% in the control group(P<0.05).Conclusion The application of titanium clip combined with hemocoagulase in the prevention and treatment of patients with colon lesions can greatly reduce the delayed bleeding, not only shorten the process of postoperative rehabilitation, but also reduce the risk of postoperative complications.