三种内镜手术治疗结肠息肉的效果及安全性观察

Effect and safety of three kinds of endoscopic surgeries on colon polyps

目的探究内镜下高频电切术、内镜下圈套器冷切除术、内镜下黏膜切除术治疗结肠息肉的效果及安全性。方法回顾性分析2021年3月至2022年3月行内镜手术切除结肠息肉95例患者的临床资料,按切除方式不同分为A组(n=29,行内镜下高频电切术)、B组(n=31,行内镜下圈套器冷切除术)和C组(n=35,行内镜下黏膜切除术)。采用SPSS 24.0软件进行数据分析,三组患者围手术期指标,术前、术后24 h血清前列腺素E2(PGE2)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平等计量资料采用单因素方差分析;息肉切除情况、并发症以及术后1年复发率等计数资料采用χ2检验。P<0.05为差异有统计学意义。结果三组患者术后胃肠功能恢复时间、住院时间差异均无统计学意义(P>0.05),C组患者内镜下操作时间长于A、B组(P<0.05),术中出血量低于A、B组(P<0.05),B组患者术中出血量高于A组(P<0.05);术后24 h三组患者血清PGE2、TNF-α、IL-6水平均高于术前(P<0.05),且B、C组均低于A组(P<0.05);术后1年三组患者复发率比较差异有统计学意义(P<0.05),且C组复发率低于A组(P<0.05)。结论三种术式治疗结肠息肉临床疗效相当,内镜下黏膜切除术在减轻术后炎症反应以及预防复发方面优于高频电切术,值得推广应用。

Objective To explore the effect and safety of endoscopic high-frequency electrical resection,endoscopic cold snare resection and endoscopic mucosal resection in the treatment of colon polyps.Methods Data of 95 patients with colon polyps who underwent endoscopic surgical resection from March 2021 to March 2022 were retrospectively analyzed,and the patients were divided into group A(29 cases,endoscopic high-frequency electrical resection),group B(31 cases,endoscopic cold snare resection)and group C(35 cases,endoscopic mucosal resection)according to different treatment methods.SPSS 24.0 software was used for statistical analysis.Perioperative indicators,levels of serum prostaglandin(PGE2),tumor necrosis factorα(TNF-α)and interleukin-6(IL-6)before surgery and at 24 hours after surgery and other measurement data were performed by One-way ANOVA of variance.Polyp resection,complications,recurrence rate at 1 year after surgery and other enumeration data were compared byχ2 test.P<0.05 was expressed as a statistical significance.Results There were no statistically significant differences in postoperative gastrointestinal function recovery time and hospital stay among the three groups(P>0.05),and the endoscopic operation time in group C was longer than that in groups A and B(P<0.05),and the intraoperative blood loss was less than that in groups A and B(P<0.05),and the intraoperative blood loss in group B was more than that in group A(P<0.05).At 24 hours after surgery,serum levels of PGE2,TNF-αand IL-6 in the three groups were higher than those before surgery(P<0.05),and the above levels in groups B and C were lower than those in group A(P<0.05).At 1 year after surgery,the difference in the recurrence rate was statistically significant among the three groups(P<0.05),and the recurrence rate was lower in group C than that in group A(P<0.05).Conclusion The clinical efficacy of the three surgical methods is comparable.Endoscopic mucosal resection is superior to high-frequency electrical resection in relieving postoperative inflammatory response and preventing recurrence,thus it is worthy of popularization and application.