摘要
目的 探究针对不足1.0 cm的结直肠息肉采用不同圈套器实施切除术的效果及安全性。方法 选取2022年2月—2023年3月郑州大学第一附属医院消化内镜中心收治直径≤1.0 cm的结直肠息肉72例患者,按治疗方法不同,将实施传统热圈套息肉切除术(hot snare polypectomy, HSP)的36例作为对照组,采用冷圈套息肉切除术(cold snare polypectomy, CSP)的36例作为观察组。比较两组患者接受治疗后切除时间、完整切除率及钛夹使用情况等相关手术指标,并通过分析比较患者血清疼痛因子、应激反应指标评价术式安全性;结果 两组患者手术相关指标方面,观察组钛夹使用率和息肉切除时间为11.11%和(2.29±0.42)min,均低于对照组(P<0.05);两组息肉回收率均为100%,观察组完整息肉切除率和完全切除率略高于对照组(P>0.05);两组治疗前血清疼痛因子前列腺素E2(PGE2)及P物质(SP)水平比较无统计学意义(P>0.05),治疗后均升高,但观察组PGE2及SP水平为(171.69±30.54)pg/mL和(1.23±0.24)μg/mL,均低于对照组(P<0.05);两组治疗前E、NE、Cor等应激反应指标比较无统计学意义(P>0.05),治疗后均上升,但观察组肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)水平分别为(261.88±35.77)pmol/L、(1.55±0.29)nmol/L和(118.41±18.35)ng/mL,均低于对照组(P<0.05)。结论 针对≤1.0 cm的结直肠息肉,采用CSP能够较HSP显著减少切除时间和钛夹使用率,并减轻患者应激水平和疼痛情况,具有较高的有效性和安全性,值得临床推广。
Objective To explore the safety and effectiveness of colorectal polyps less than 1.0 cm for resection of using different snares.Methods Selected 72 patients with colorectal polyps with a diameter ≤ 1.0 cm from October 2021 to October 2023 in hospital.The control group underwent traditional hot snare polypectomy(HSP),while the observation group underwent cold snare polypectomy(CSP).Compared the surgical indicators such as resection time, complete resection rate, and titanium clip usage between two groups of patients after treatment, and evaluated the safety of the surgical procedure by analyzing and comparing the patient's serum pain factors and stress response indicator.Results In terms of surgery-related indicators, the utilization rate of titanium clip and polyp removal time in the observation group were 11.11% and(2.29±0.42) min, both lower than those in the control group(P<0.05),the polyp recovery rates in both groups were 100%,and the complete and complete polyp removal rates in the observation group were slightly higher than those in the control group(P>0.05).There was no statistical significance in serum pain factor PGE_2 and SP levels between the two groups before treatment(P>0.05),but the levels of PGE_2 and SP in the observation group were(171.69±30.54) pg/mL and(1.23±0.24) μg/mL,which were lower than those in the control group(P<0.05).There was no statistical significance in stress response indexes of E,NE and Cor between the two groups before treatment(P>0.05),but the levels of E,NE and Cor in the observation group were(261.88±35.77) pmol/L,(1.55±0.29) nmol/L and(118.41±18.35) ng/mL,respectively.Which were lower than those in the control group(P<0.05).Conclusion For colorectal polyps ≤ 1.0cm, using CSP can significantly reduce resection time and titanium clip usage compared to HSP,as well as alleviate patient stress levels and pain.It has high effectiveness and safety, and is worthy of clinical promotion.
作者
程亭亭
肖钊
高倩
CHENG Ting-ting;XIAO Zhao;GAO Qian(Digestive Endoscopy Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《医药论坛杂志》
2024年第10期1028-1032,共5页
Journal of Medical Forum
