电子结肠镜下圈套器冷切除术与氩离子束凝固术治疗无蒂结直肠息肉的效果比较

Comparison of the Effect of Cold Snare Polypectomy and Argon Plasma Coagulation under Electronic Colonoscope in the Treatment of Pediceless Colorectal Polyp

目的:观察比较无蒂结直肠息肉患者经电子结肠镜下圈套器冷切除术治疗或氩离子束凝固术治疗的临床效果。方法:将2021年8月—2022年8月就诊于盐城市第一人民医院消化内科的150例无蒂结直肠息肉患者用随机数字表法进行对照探讨。对照组(n=75)给予电子结肠镜下氩离子束凝固术治疗,试验组(n=75)给予电子结肠镜下圈套器冷切除术治疗。比较两组手术时间、术中息肉切除时间、住院时间、息肉完整切除率、血清学指标[脂多糖(LPS)、C反应蛋白(CRP)、基质金属蛋白酶-2(MMP-2)]、术后并发症。结果:与对照组比较,试验组手术时间、术中息肉切除时间均更长,息肉完整切除率更低,差异均有统计学意义(P<0.05)。两组住院时间比较,差异无统计学意义(P>0.05)。术后72 h,两组LPS、CRP均升高,但试验组LPS、CRP均低于对照组,差异均有统计学意义(P<0.05);术后72 h,两组MMP-2比较,差异无统计学意义(P>0.05);试验组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:电子结肠镜下圈套器冷切除术耗时长,但并发症较少,安全性相对更高,而氩离子束凝固术能够完整切除息肉,避免息肉残留。二者各有优势,建议临床根据患者需要选取最佳术式。

Objective:To observe and compare the clinical effects of patients with pediceless colorectal polyp treated by cold snare polypectomy or argon plasma coagulation under electronic colonoscope.Method:A total of 150 patients with pediceless colorectal polyp who were admitted to the Department of Gastroenterology,Yancheng NO.1 People's Hospital from August 2021 to August 2022 were compared and discussed according to random number table method.The control group(n=75)was treated with argon plasma coagulation under electronic colonoscope,and the experimental group(n=75)was treated with cold snare polypectomy under electronic colonoscope.The operation time,intraoperative polypectomy time,hospital stay,complete polypectomy rate,serological indexes[lipopolysaccharide(LPS),C reactive protein(CRP),matrix metalloproteinase-2(MMP-2)]and postoperative complications were compared between the two groups.Result:Compared with the control group,the operative time and intraoperative polypectomy time of experimental group were longer,and the complete polypectomy rate was lower,the differences were statistically significant(P<0.05).There was no significant difference in hospital stay between the two groups(P>0.05).72 h after operation,LPS and CRP were increased in both groups,but LPS and CRP in experimental groups were lower than those in control group,the differences were statistically significant(P<0.05).72 h after operation,there was no significant difference in MMP-2 between the two groups(P>0.05).The incidence of postoperative complications in experimental group was lower than that in control group,the difference was statistically significant(P<0.05).Conclusion:Cold snare polypectomy under electronic colonoscope takes a long time,but has fewer complications and relatively higher safety,while argon plasma coagulation can completely remove polyp and avoid polyp residue.Both have their own advantages,it is recommended to choose the best operation according to the needs of patients.