无痛内镜下冷切除与高频电切在结直肠息肉治疗中的应用价值

Application Value of Painless Endoscopic Cold Resection and High-frequency Electrotomy in the Treatment of Colorectal Polyps

目的:探究无痛内镜下冷切除与高频电切在结直肠息肉治疗中的应用价值。方法:选择2018年1月—2021年12月在大连市第三人民医院消化科治疗的结直肠息肉患者180例,应用随机数字表法将其分为对照组(无痛内镜下高频电切)及观察组(无痛内镜下冷切除),各90例。对比两组临床指标(手术时间、术后禁食时间、排便时间)、治疗总有效率、炎症因子[C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]、应激指标[肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)]、并发症发生率。结果:观察组手术时间、术后禁食时间、排便时间均短于对照组,差异均有统计学意义(P<0.05)。对照组治疗总有效率低于观察组,差异有统计学意义(P<0.05)。术前,两组IL-1β、IL-6、CRP水平对比,差异均无统计学意义(P>0.05);术后,两组IL-1β、IL-6、CRP水平均升高,但观察组均低于对照组,差异均有统计学意义(P<0.05)。术前,两组E、NE、Cor水平对比,差异均无统计学意义(P>0.05);术后,两组E、NE、Cor水平均升高,但观察组均低于对照组,差异均有统计学意义(P<0.05)。对照组并发症发生率高于观察组,差异有统计学意义(P<0.05)。结论:相较高频电切治疗结直肠息肉,无痛内镜下冷切除效果更佳,可促进患者恢复,减轻炎症反应、应激损伤,降低并发症,安全性较高。

Objective:To explore the application value of painless endoscopic cold resection and highfrequency electrotomy in the treatment of colorectal polyps.Method:A total of 180 patients with colorectal polyps who were treated in the Gastroenterology Department of Dalian NO.3 People's Hospital from January 2018 to December 2021 were selected,the patients were divided into control group(painless endoscopic high-frequency electrotomy)and observation group(painless endoscopic cold resection)by random number table method,90 cases in each group.Clinical indexes(operation time,postoperative fasting time,defecation time),total treatment response rate,inflammatory factors[C reactive protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6)],stress indexes[epinephrine(E),norepinephrine(NE),cortisol(Cor)]and complication rate of the two groups were compared.Result:The operation time,postoperative fasting time and defecation time in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of the control group was lower than that of the observation group,the difference was statistically significant(P<0.05).Before operation,there were no significant differences in IL-1β,IL-6 and CRP levels between the two groups(P>0.05);after operation,the levels of IL-1β,IL-6 and CRP in both groups were increased,but the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in E,NE and Cor levels between the two groups(P>0.05);after operation,the levels of E,NE and Cor were increased in both groups,but the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The complication rate of the control group was higher than that of the observation group,the difference was statistically significant(P<0.05).Conclusion:Compared with high-frequency electrotomy for colorectal polyps,painless endoscopic cold resection has better effect,which can promote patient recovery,reduce inflammation,stress damage,and reduce complications,with high safety.