内镜下黏膜切除术与高频电凝套扎术治疗胃肠道息肉的疗效及安全性比较

Clinical Effectiveness and Safety of Endoscopic Mucosal Resection and High-Frequency Electrocoagulation and Ligation in Treating the Gastrointestinal Polyposis

目的比较内镜下黏膜切除术与高频电凝套扎术治疗胃肠道息肉的疗效及安全性。方法选择2018年12月至2021年12月驻马店市新蔡月亮湾医院收治的60例胃肠道息肉病患为研究主体。按随机数字表法,将全部病患划分成常规组(30例)、试验组(30例),常规组病患应用高频电凝套扎,试验组病患应用内镜下黏膜切除术。针对每组病患手术有关指标、治疗效果、整块切除率、完整切除率、并发症及各时期炎症指标进行比较。结果试验组病患手术时间、息肉切除时间、住院时间及手术后开始进食流质时间均短于常规组,出血量低于常规组,差异有统计学意义(P<0.05)。试验组治疗有效率(93.33%)高于常规组(73.33%),差异有统计学意义(P<0.05)。试验组病患息肉整块切除率(96.67%)高于常规组(80.00%),试验组病患息肉完整切除率(100.00%)高于常规组(83.33%),差异有统计学意义(P<0.05)。试验组并发症出现率(6.67%)低于常规组(26.67%),差异有统计学意义(P<0.05)。手术前两组病患降钙素原、C反应蛋白、白细胞介素-6水平对比,差异无统计学意义(P>0.05);同组组内手术后降钙素原、C反应蛋白、白细胞介素-6水平均高于手术前,手术后试验组病患降钙素原、C反应蛋白、白细胞介素-6水平均低于常规组,差异有统计学意义(P<0.05)。结论胃肠道息肉病患实施内镜下黏膜切除手术治疗,能够改善手术有关指标,提升整块切除率、完整切除率及治疗效果,对病患机体损伤较少,炎症反应轻微,并发症少,安全性良好。

Objective To compare the efficacy and safety of endoscopic mucosal resection and high-frequency electrocoagulation in the treatment of gastrointestinal polyps.Methods A total of 60 gastrointestinal polyposis patients treated in our hospital from December 2018 to December 2021 were selected as research subjects.All patients were divided into routine group(30 cases)and experimental group(30 cases)by the random number table method.The high-frequency electrocoagulation and ligation was performed in the routine group and the endoscopic mucosal resection was performed in the test group.The surgical indicators,treatment effect,the whole resection rate,complete resection rate,clinical complications and inflammatory factors were compared between two groups.Results The operation time,polyp resection time,hospital stays and food intake time in the test group were shorter than those in the routine group,the bleeding volume in the test group was smaller than that in the routine group(P<0.05);The total effective rate in the test group and routine group was 93.33%and 73.33%respectively,with significant difference(P<0.05);The whole resection rate in the test group was 96.67%,significantly higher than that in the routine group which was 80.00%(P<0.05);The complete resection rate in the test group was 100.00%,significantly higher than that in the routine group which was 83.33%(P<0.05);The overall complication rate in the test group and routine group was 6.67%and 26.67%respectively,with significant difference(P<0.05);Before surgery,procalcitonin,C-reactive protein and Interleukin-6 levels between groups were not significantly different(P>0.05);After surgery,procalcitonin,C-reactive protein and Interleukin-6 levels in two groups were higher than before,the above indicators in the test group were lower than those in the routine group(P<0.05).Conclusion The endoscopic mucosal resection can ameliorate the relevant indicators of surgery,improve the whole block resection rate,complete resection rate and treatment effect,with less damage to the patient's body,mild inflammatory response,less complications,and good safety.