冷圈套黏膜切除术对直径≤1.0 cm结直肠息肉患者血清疼痛因子、应激反应及VEGF、TXB2水平的影响

Effects of Cold Snare Polypectomy on Serum Pain Factor,Stress Response,VEGF and TXB2 Levels in Patients with Colorectal Polyps≤1.0 cm in Diameter

目的:探讨冷圈套黏膜切除术(CSP)对直径≤1.0 cm结直肠息肉患者血清疼痛因子、应激反应及血管内皮生长因子(VEGF)、血栓素B2(TXB2)水平的影响。方法:选取2021年3月~2022年3月期间湖南师范大学附属第一医院收治的97例行内镜下切除术直径≤1.0 cm结直肠息肉患者,采用随机数字表法将患者分为A组[热圈套息肉切除术(HSP)治疗,48例]和B组(CSP治疗,49例)。对比两组临床指标、并发症发生率、血清疼痛因子指标[前列腺素E_(2)(PGE_(2))、P物质(SP)]、应激反应指标[肾上腺素(E)、皮质醇(Cor)、去甲肾上腺素(NE)]及VEGF、TXB2水平。结果:B组手术时间短于A组,住院费用少于A组(P<0.05)。B组患者术后1 d PGE_(2)、SP水平低于A组(P<0.05)。B组患者术后1 d E、Cor、NE水平均低于A组(P<0.05)。B组患者术后1 d VEGF、TXB2水平均低于A组(P<0.05)。两组并发症发生率组间对比无差异(P>0.05)。结论:CSP、HSP治疗直径≤1.0 cm结直肠息肉患者,息肉完整切除率、切除息肉数量相当,但CSP可明显缩短手术时间,降低住院费用,减轻应激反应程度,降低血清疼痛因子和VEGF、TXB2水平。

Objective:To investigate the effects of cold snare polypectomy(CSP)on serum pain factor,stress response,vascular endothelial growth factor(VEGF),thromboxane B2(TXB2)levels in patients with colorectal polyps≤1.0 cm in diameter.Methods:97 patients with colorectal polyps≤1.0 cm in diameter undergoing endoscopic resection who were admitted to the The First Affiliated Hospital of Hunan Normal University from March 2021 to March 2022 were select,and the patients were divided into group A[hot snare polypectomy(HSP),48 cases]and Group B(CSP,49 cases)by random number table.The clinical indexes,complication rate,serum pain factor indexes[prostaglandin E2(PGE2),Substance P(SP)],stress response indexes[epinephrine(E),cortisol(Cor),norepinephrine(NE)],VEGF and TXB2 levels were compared in the two groups.Results:The operation time in the group B was shorter than that in the group A,and the hospitalization cost was less than that in the group A(P<0.05).The PGE_(2) and SP levels in the group B were lower than those in the group A at 1 d after operation(P<0.05).The E,Cor and NE levels in the group B were lower than those in the group A at 1 d after operation(P<0.05).The VEGF and TXB2 levels in the group B were lower than those in the group A at 1 d after operation(P<0.05).There was no difference in the incidence rate of complications in the two groups(P>0.05).Conclusion:In the treatment of patients with colorectal polyps≤1.0 cm in diameter,the complete polypectomy rate and number of polyps removed are equivalent,but CSP can significantly shorten the operation time,reduce hospitalization cost,reduce stress response,and reduce serum pain factor,VEGF and TXB2 levels.