微生态制剂辅助内镜下高频电凝电切术对结肠息肉的疗效及对患者肠道菌群和血清炎症因子的影响

Effect of micro-ecological preparation assisted endoscopic high-frequency electrocoagulation and electroresection on colon polyps and its influence on intestinal flora and serum inflammatory factors

目的探讨微生态制剂辅助内镜下高频电凝电切术治疗结肠息肉的效果,为该类患者的治疗提供参考。方法选取我院2019年1月至2022年12月收治的368例结肠息肉患者为研究对象,入选患者采用随机数字表分为手术组和联合组,各184例。手术组患者采用内镜下高频电凝电切术治疗,联合组患者在手术组基础上给予微生态制剂(复方嗜酸乳杆菌片)辅助治疗。评估两组患者围术期指标,术后4周肠道黏膜愈合情况,术前与术后3个月肠道菌群变化情况,术前与术后3个月血清炎症因子水平[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)],统计两组患者术后3个月、6个月复发率。结果两组患者围术期指标比较差异均无统计学意义(均P>0.05)。联合组患者肠道黏膜修复情况优于手术组(P<0.05)。术后3个月,联合组患者肠道双歧杆菌、乳杆菌数量高于手术组,大肠埃希菌数量低于手术组,血清IL-6、TNF-α水平低于手术组(均P<0.05)。联合组患者术后3个月、6个月复发率(0.00%、2.72%)均低于手术组(3.80%、11.41%)(均P<0.05)。结论微生态制剂辅助内镜下高频电凝电切术治疗结肠息肉的效果良好,可纠正患者肠道菌群紊乱,促进肠道黏膜修复,减轻炎症反应,有助于患者降低复发率。

Objective To observe the effect of micro-ecological preparation assisted endoscopic high-frequency electrocoagulation and electroresection in the treatment of colon polyps,providing a reference for the treatment.Methods A total of 368 patients with colonic polyps treated in our hospital from Jan.2019 to Dec.2022 were selected as the research object.The selected patients were randomly divided into surgery group and combination group,with 184 cases in each group.The patients in the surgery group were treated by endoscopic high frequency electrocoagulation and electrotomy,while those in the combination group were additionally given micro-ecological preparation(Compound Lactobacillus acidophilus Tablets)as adjuvant therapy.Perioperative indexes,intestinal mucosal healing four weeks after surgery,intestinal flora changes before and three months after surgery,and serum inflammatory factor levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]before and three months after surgery in the two groups were evaluated,and the recurrence rates at three months and six months after surgery were analyzed.Results There were no statistically significant differences in the perioperative indicators between the two groups(all P>0.05).The repair of intestinal mucosa in the combination group was better than that in the surgery group(P<0.05).Three months after operation,the counts of Bifidobacterium and Lactobacillus in the combination group were higher,while that of Escherichia coli was lower than those in the surgery group respectively,and the serum IL-6 and TNF-αwere lower than those in the surgery group respectively(all P<0.05);the recurrence rate(0.00%,2.72%)in the combination group was lower than that in the surgery group(3.80%,11.41%)at three and six months after operation,respectively(all P<0.05).Conclusion Microecological preparation assisted endoscopic high-frequency electrocoagulation and electroresection has positive effect in the treatment of colon polyps,which can correct intestinal flora disturbance,promote intestinal mucosal repair,reduce inflammation and help reduce the recurrence rate.