电子肠镜下黏膜切除术与无痛电子肠镜下黏膜切除术治疗肠息肉的效果比较

Comparison of effect of electronic colonoscopic mucosal resection and painless electronic enteroscopic mucosal resection in the treatment of intestinal polyps

目的对比分析电子肠镜下黏膜切除术与无痛电子肠镜下黏膜切除术治疗肠息肉的临床效果。方法队列研究。抽取2019年8月至2022年8月新乡市中心医院收治的肠息肉患者200例, 按随机数字表法分为无痛组与常规组, 每组100例。常规组采取电子肠镜下黏膜切除术治疗, 无痛组采取无痛电子肠镜下黏膜切除术治疗。对比两组临床效果, 围术期情况(手术时间、排气时间、术中出血量、住院时间), 胃肠功能(胃泌素、胃动素), 去甲肾上腺素(NE)、皮质醇(Cor)、肾上腺素(E)水平, 炎症因子水平[C反应蛋白(CRP)、白细胞介素-6(IL-6)]及并发症发生率。结果无痛组总有效率(94.00%, 94/100)高于常规组(74.00%, 74/100), P<0.05;无痛组排气时间、手术时间、住院时间短于常规组, 术中出血量少于常规组(P<0.05);术后6 h, 无痛组胃泌素、胃动素水平均高于常规组(P均<0.05);术后1 d, 无痛组NE、Cor、E水平均低于常规组(P均<0.05);术后3 d, 无痛组CRP、IL-6水平均低于常规组(P均<0.05);无痛组并发症发生率(6.00%, 6/100)低于常规组(20.00%, 20/100), P<0.05。结论对肠息肉患者采用无痛电子肠镜下黏膜切除术, 可提高临床效果, 减轻对胃肠功能的刺激, 并能改善机体应激反应, 可加快患者术后恢复, 降低并发症发生率。

Objective To compare the effect of electronic colonoscopic mucosal resection and painless electronic colonoscopic mucosal resection in the treatment of intestinal polyps.Methods A total of 200 patients with intestinal polyps treated in Xinxiang Central Hospital from August 2019 to August 2022 were selected for the cohort study.And they were divided into the painless group and the conventional group according to random number table method,with 100 cases in each group.The conventional group was treated by electronic colonoscopic mucosal resection,while the painless group was treated by painless electronic colonoscopic mucosal resection.The clinical effects,perioperative conditions(operation duration,exhaust time,intraoperative blood loss,length of hospital stay),gastrointestinal function assessed by gastrin and motilin,levels of norepinephrine(NE),cortisol(Cor)and epinephrine(NE),levels of inflammatory cytokines,including C-reactive protein(CRP)and interleukin-6(IL-6),and incidence of complications were compared between the two groups.Results The total effective rate of the painless group(94.00%,94/100)was higher than that of the conventional group(74.00%,74/100),P<0.05.The exhalation time,operation duration and hospital stay in the painless group were shorter than those in the conventional group,moreover,the amount of intraoperative blood loss in the painless group was less(P<0.05).The levels of gastrin and motilin in the painless group were higher than those in the conventional group at 6 hours after operation(all P<0.05).One day after surgery,the levels of NE,Cor and E in the painless group were lower than those in the conventional group(all P<0.05).The levels of CRP and IL-6 in the painless group were lower than those in the conventional group 3 days after operation(all P<0.05).The incidence of complications in the painless group(6.00%,6/100)was lower than that in the conventional group(20.00%,20/100),P<0.05.Conclusions Painless electronic colonoscopy mucosal resection has better clinical effects on patients with intestinal polyps,which can reduce the impact on gastrointestinal function,improve the body stress response,accelerate the postoperative recovery of patients,and reduce the incidence of complications.