无痛消化内镜下高频电刀手术治疗老年胃肠息肉患者的效果

Effect of high frequency electrosurgical operation under painless digestive endoscopy in treatment of elderly patients with gastrointestinal polyps

目的:观察无痛消化内镜下高频电刀手术治疗老年胃肠息肉患者的效果。方法:选取2019年6月至2021年6月该院收治的90例老年胃肠息肉患者进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各45例。对照组行常规消化内镜下高频电刀手术治疗,观察组行无痛消化内镜下高频电刀手术治疗,比较两组围术期指标(手术时间、术中出血量、术后排气时间、术后2 h疼痛评分、住院时间)水平、术前和术后1周胃肠激素指标[胃泌素(GAS)、血管活性肠肽(VIP)、胃动素(MOT)]水平、氧化应激指标[5-羟色胺(5-HT)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、总抗氧化能力(T-AOC)]水平,以及并发症发生率。结果:观察组手术时间、术后排气时间、住院时间均短于对照组,术中出血量少于对照组,术后2 h疼痛评分低于对照组,差异有统计学意义(P<0.05);术后1周,两组GAS、MOT、GSH-Px、T-AOC水平均低于术前,但观察组高于对照组,两组VIP、5-HT、MDA水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为4.44%(2/45),低于对照组的22.22%(10/45),差异有统计学意义(P<0.05)。结论:无痛消化内镜下高频电刀手术治疗老年胃肠息肉患者可优化围术期指标水平,改善术后胃肠激素指标和氧化应激指标水平,降低并发症发生率,效果优于常规消化内镜下高频电刀手术治疗。

Objective:To observe effect of high frequency electrosurgical operation under painless digestive endoscopy in treatment of elderly patients with gastrointestinal polyps.Methods:A prospective study was conducted on 90 elderly patients with gastrointestinal polyps admitted to the hospital from June 2019 to June 2021.They were divided into observation group and control group according to the random number table method,45 cases in each.The control group was treated with high frequency electrosurgical operation under conventional digestive endoscopy,while the observation group was treated high frequency electrosurgical operation under painless digestive endoscopy.The perioperative index levels(operation time,intraoperative blood loss,postoperative exhaust time,pain score at 2 h after the surgery,hospitalization time),the gastrointestinal hormone index levels[gastrin(GAS),vasoactive intestinal peptide(VIP),motilin(MOT)],the oxidative stress index levels[5-hydroxytryptamine(5-HT),malondialdehyde(MDA),glutathione peroxidase(GSH-Px),total antioxidant capacity(T-AOC)],and the incidence of complications were compared between the two groups.Results:The operation time,the postoperative exhaust time and the hospitalization time of the observation group were shorter than those of the control group;the intraoperative blood loss less than the control group;the pain score 2 h after the surgery was lower than that of the control group;and the difference was statistically significant(P<0.05).1 week after the surgery,the levels of GAS,MOT,GSH-Px and T-AOC in the two groups were lower than those before the surgery,and those in the observation group were higher than those in the control group;the levels of VIP,5-HT and MDA in the two groups were higher than those before the surgery,and those in the observation group were lower than those in the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications of the observation group was 4.44%(2/45),which was lower than 22.22%(10/45)in the control group,and the difference was statistically significant(P<0.05).Conclusions:High-frequency electrosurgical operation under painless digestive endoscopy in the treatment of the elderly patients with gastrointestinal polyps can optimize the perioperative index levels,improve the postoperative gastrointestinal hormone index and oxidative stress index levels,and reduce the incidence of complications.Moreover,it is superior to high frequency electrosurgical operation under conventional digestive endoscopy.