电子结肠镜下冷圈套器息肉切除术治疗老年无蒂结直肠息肉患者的效果

Effects of cold snare polypectomy under electronic colonoscopy in treatment of elderly patients with sessile colorectal polyps

目的:观察电子结肠镜下冷圈套器息肉切除术(CSP)治疗老年结直肠无蒂息肉患者的效果。方法:选取2021年6月至2022年7月该院收治的150例老年结直肠无蒂息肉患者进行前瞻性研究,按随机数字表法将其分为对照组与观察组各75例。对照组行电子结肠镜下热圈套器息肉切除术(HSP)治疗,观察组行电子结肠镜下CSP治疗,比较两组围术期指标水平,手术前后应激指标[皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)]水平、胃肠功能指标[血清肠脂肪酸结合蛋白(IFABP)、二胺氧化酶(DAO)、D-乳酸]水平,以及术后1个月并发症发生率和术后3个月复发率。结果:观察组息肉切除时间短于对照组,差异有统计学意义(P<0.05);两组息肉切除个数比较,差异无统计学意义(P>0.05);术后,两组E、NE、Cor水平均高于治疗前,但观察组低于对照组,差异有统计学意义(P<0.05);术后,两组DAO、IFABP、D-乳酸水平均低于治疗前,但组间比较,差异无统计学意义(P>0.05);观察组并发症发生率为2.67%(2/75),低于对照组的12.00%(9/75),差异有统计学意义(P<0.05);两组复发率比较,差异无统计学意义(P>0.05)。结论:电子结肠镜下CSP治疗老年结直肠无蒂息肉患者可缩短息肉切除时间,降低应激指标水平和并发症发生率,效果优于电子结肠镜下HSP治疗。

Objective:To observe effects of cold snare polypectomy(CSP)under electronic colonoscopy in the treatment of elderly patients with sessile colorectal polyps.Methods:A prospective study was conducted on 150 elderly patients with sessile colorectal polyps admitted to this hospital from June 2021 to July 2022.They were divided into control group and observation group according to the random number table method,75 cases in each group.The control group was treated with hot snare polypectomy(HSP)under electronic colonoscopy,while the observation group was treated with CSP under electronic colonoscopy.The levels of perioperative indexes,stress indexes[cortisol(Cor),epinephrine(E),norepinephrine(NE)]before and after the surgery,and gastrointestinal function indexes[serum intestinal fatty acid binding protein(IFABP),diamine oxidase(DAO),D-lactic acid],the incidence of complications 1 month after the surgery,and the recurrence rate 3 months after the surgery were compared between the two groups.Results:The resection time of polyps in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).After the surgery,the levels of E,NE and Cor in the two groups were higher than those before the treatment,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the levels of DAO,IFABP,and D-lactate in both groups were lower than those before the treatment,but there were no statistically significant differences between the groups(P>0.05).The incidence of complications in the observation group was 2.67%(2/75),which was lower than 12.00%(9/75)in the control group,and the difference was statistically significant(P<0.05).Conclusions:CSP under electronic colonoscopy in the treatment of the elderly patients with sessile colorectal polyps can shorten the resection time of polyps and reduce the levels of stress indexes and the incidence of complications.Moreover,it is superior to HSP treatment under electronic colonoscopy.