无痛胃肠镜下氩气刀切除术治疗胃肠息肉的效果

Effect of painless gastrointestinal endoscopic resection with argon plasma coagulation on gastrointestinal polyps

目的探讨无痛胃肠镜下氩气刀切除术治疗胃肠息肉的效果。方法队列研究。抽取2022年1月至2023年12月郑州大学第一附属医院收治的胃肠息肉患者62例,按随机数字表法分为无痛组和常规组,每组31例。无痛组采用无痛胃肠镜下氩气刀切除术,常规组采用常规内镜下氩气刀切除术。比较两组围术期指标、术后视觉模拟评分法(VAS)评分、疼痛应激指标[C反应蛋白(CRP)、皮质醇(Cor)、前列腺素E2(PGE2)]水平及并发症发生率。结果无痛组手术操作时长、术后肠鸣音消失时间及术中出血量均少于对照组(P均<0.05)。术后3、6、12 h,无痛组VAS评分均低于常规组(P均<0.05);术后6 h,无痛组CRP、Cor、PGE2水平低于常规组(P<0.05)。无痛组并发症发生率(3.23%,1/31)低于常规组(25.81%,8/31),P<0.05。结论无痛胃肠镜下氩气刀切除术用于胃肠息肉患者中可减少出血量,缩短手术操作时长,减轻机体疼痛和应激反应,促进患者术后恢复,且并发症较少,安全性良好。

Objective To investigate the effect of painless gastrointestinal endoscopic resection with argon plasma coagulation on gastrointestinal polyps.Methods Sixty-two patients with gastrointestinal polyps treated in the First Affiliated Hospital of Zhengzhou University from January 2022 to December 2023 were selected for the cohort study,and they were divided into a painless group and a conventional group according to random number table method,with 31 cases in each group.The painless group was treated by painless gastrointestinal endoscopic resection with argon plasma coagulation,and the conventional group was treated by conventional endoscopic argon plasma coagulation.The perioperative indexes,postoperative visual analogue scale(VAS)score,pain stress response indexes,including C-reactive protein(CRP),cortisol(Cor)and prostaglandin E2(PGE2),and incidence of complications were compared between the two groups.Results Compared with the conventional group,the painless group had a shorter surgical operation time,a shorter time for the disappearance of postoperative bowel sounds,and less intraoperative bleeding(P<0.05).At 3,6,and 12 hours postoperatively,the VAS scores of the painless group were lower than those of the conventional group(all P<0.05);at 6 hours postoperatively,the levels of CRP,Cor,and PGE2 in the painless group were lower than those in the conventional group(P<0.05).The incidence of complications in the painless group(3.23%,1/31)was lower than that in the conventional group(25.81%,8/31),P<0.05.Conclusions Painless gastrointestinal endoscopic resection with argon plasma coagulation in the treatment of gastrointestinal polyp can reduce the amount of bleeding,shorten the duration of surgical operation,reduce the body pain and stress response,promote postoperative recovery,with fewer complications and good safety.