单纯电切、单纯电凝与电凝电切术对扁平肠息肉疗效及不良事件发生率的影响

Effect of electrodesiccation alone,electrocoagulation alone and electrocoagulation-electrodesiccation on the efficacy of flat intestinal polyps and the incidence of adverse events

目的比较单纯电切、单纯电凝和电凝电切术对直径为5~10 mm扁平肠息肉的疗效及不良事件发生率的影响。方法前瞻性纳入2021年3月至2023年3月于解放军总医院第四医学中心就诊的221例直径5~10 mm的扁平肠息肉患者,经纳入排除标准筛选,同时剔除不愿参与研究及中途退出者,最终纳入195例患者作为研究对象。根据随机字母表法将所有患者分为单纯电切组、单纯电凝组、电凝电切术组,每组65例患者。观察比较三组患者的完全切除率、息肉复发率、手术及住院情况、胃肠道功能恢复时间、不良事件发生率和患者满意度。结果术后,电凝电切术组的完全切除率为96.92%,显著高于单纯电切组(81.54%)和单纯电凝组(84.62%)。尽管三组在息肉复发率上差异不显著,但电凝电切术组的不良事件发生率显著低于其他两组,仅为1.54%。此外,电凝电切术组的手术、恢复和住院时间也都显著短于单纯电切和单纯电凝组,同时在胃肠道功能恢复时间方面也表现更好,患者满意度更高。结论相比于单纯电切或电凝,电凝电切术治疗直径为5~10 mm的扁平肠息肉疗效更好,能更快促进胃肠道功能恢复,且不良事件发生率低,患者满意度高。

Objective To compare the effects of electrodesiccation alone,electrocoagulation alone,and electrocoagulation-electrodesiccation on the efficacy of flat intestinal polyps with diameters of 5-10 mm and the incidence of adverse events.Methods A total of 221 patients with flat intestinal polyps with a diameter of 5-10 mm who attended the Fourth Medical Center of the Chinese People's Liberation Army General Hospital from March 2021 to March 2023 were prospectively enrolled,and 195 patients were finally included in the study after being screened by inclusion and exclusion criteria,while those who were unwilling to participate in the study and those who withdrew in the middle of the study were excluded.According to the randomized alphabetical method,all the patients were divided into electrodesiccation alone group,electrocoagulation alone group,and electrocoagulation-electrodesiccation group,with 65 patients in each group.The complete resection rate,polyp recurrence rate,operation and hospitalization,recovery time of gastrointestinal function,incidence of adverse events,and patient satisfaction of the three groups were compared.Results Postoperatively,the complete resection rate in the electrocoagulation-electrodesiccation group was 96.92%,which was significantly higher than that in the electrodesiccation alone group(81.54%)and the electrocoagulation alone group(84.62%).Although the difference in polyp recurrence rate among the three groups was not significant,the incidence of adverse events in the electrocoagulation-electrodesiccation group was significantly lower than that of the other two groups,which was only 1.54%.In addition,the procedure,recovery and hospitalization times were also significantly shorter in the electrocoagulation-electrodesiccation group than that in the electrodesiccation alone group and electrocoagulation alone group,as well as better in terms of recovery time of gastrointestinal function and higher patient satisfaction.Conclusion Compared with electrodesiccation alone or electrocoagulation alone,electrocoagulation-electrodesiccation has better efficacy in the treatment of flat intestinal polyps with a diameter of 5-10 mm,promotes the recovery of gastrointestinal function more quickly,has a low incidence of adverse events,and has a high degree of patient satisfaction.