经肛门内镜微创手术治疗直肠息肉的疗效观察

Clinical Efficacy of Transanal Endoscopic Microsurgery in Treating Rectal Polyps

目的:观察经肛门内镜微创手术(TEM)治疗直肠息肉的疗效。方法:将2020年6月至2023年6月在我院确诊并行手术治疗的直肠息肉患者92例随机分为对照组和观察组,每组46例。对照组患者行腹腔镜下切除直肠息肉,观察组患者行TEM切除直肠息肉,比较2组患者的疗效及息肉完全切除率,观察2组手术相关指标、术后疼痛、手术前后心理状态以及术后不良反应发生率。结果:2组患者治疗总有效率比较差异无统计学意义(P>0.05),但观察组患者息肉完全切除率明显高于对照组(P<0.05);观察组患者手术时间、术后首次排气时间、住院时间明显短于对照组(P<0.05),术中出血量明显少于对照组(P<0.05);观察组患者术后1d、7d、14d疼痛评分明显低于对照组(P<0.05);术前2组患者焦虑自评量表(SAS)和抑郁自评量表(SDS)评分比较差异无统计学意义(P>0.05),术后14d2组患者SAS、SDS评分均较术前有所下降,但观察组明显低于对照组(P<0.05);观察组患者不良反应发生率明显低于对照组(P<0.05)。结论:TEM治疗直肠息肉效果显著,能够提高息肉完全切除率,缩短手术时间、住院时间、减少术中出血量,有效缓解患者术后疼痛及负面心理,术后不良反应少,有推广使用意义。

Objective To observe the efficacy of transanal endoscopic microsurgery(TEM)in the treat-ment of rectal polyps.Methods From June 2020 to June 2023,total 92 patients with rectal polyps who were diagnosed and underwent surgical treatment in our hospital were randomly divided into control group and observation group,46 cases in each group.The control group underwent laparoscopic resection of rec-tal polyps,while the observation group underwent TEM resection of rectal polyps.The efficacy and com-plete removal rate of polyps in the two groups were compared,and the relevant indexes of surgery,postop-erative pain,psychological state before and after surgery,and the incidence of postoperative adverse reac-tions were observed in the two groups.Results There was no significant difference in the total effective rate between the two groups(P>0.05),but the complete removal rate of polyps in the observation group was significantly higher than that in the control group(P<0.05).The operation time,the first postoperative exhaust time and the hospital stay in the observation group were significantly shorter than those in the control group(P<0.05),and the intraoperative blood loss in the observation group was sig-nificantly less than that in the control group(P<0.05).The pain scores of the observation group were significantly lower than those of the control group on the 1st,7th and 14th day after surgery(P<0.05).There was no significant difference in the scores of Self-Rating Anxiety Scale(SAS)and Self-Rating De-pression Scale(SDS)between the two groups before surgery(P>0.05).On the 14th day after surgery,the scores of SAS and SDS in the two groups were decreased,which were lower in the observation group than in the control group(P<0.05).The incidence of adverse reactions in the observation group was sig-nificantly lower than that in the control group(P<0.05).Conclusion TEM is effective in the treat-ment of rectal polyps,which can improve the complete removal rate of polyps,shorten the operation time and hospital stay,decrease the amount of intraoperative blood loss,effectively relieve postoperative pain and negative psychology of patients,and reduce postoperative adverse reactions.