常规手术与EMR治疗消化道息肉的临床疗效观察  

Clinical Observation of Routine Surgery and EMR in the Treatment of Gastrointestinal Polyps

作　　者：孙岩岩 SUN Yan-yan(Department of Gastroenterology,Shangqiu First People's Hospital,Shangqiu 476100,Henan Province,China)

机构地区：[1]商丘第一人民医院消化内科,河南商丘476100

出　　处：《罕少疾病杂志》2023年第2期68-70,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的观察常规手术与内镜下黏膜切除术(EMR)治疗消化道息肉的临床疗效。方法2020年4月至2021年4月本院收治的消化道息肉患者86例,按随机数字表法分2组,对照组(n=42)予高频电切术,研究组(n=44)予EMR。比较息肉切除情况、围术期指标、住院时间、胃肠道功能影响情况、胃肠道激素水平、炎性因子、随访1年复发情况。结果研究组整块切除率(97.73%,43/44)、完整切除率(100%,44/44)均较对照组(83.33%,35/42)、(88.10%,37/42)高(P<0.05)。研究组手术时间、术后禁食时间、住院时间较对照组短(P<0.05),术中出血率、迟发性出血率较对照组差异无统计学意义(P>0.05)。研究组胃肠道不适情况总发生率(25.00%,11/44)较对照组(50.00%,21/42)低(P<0.05)。术后24h,2组胃动素、胃泌素均较术前低(P<0.05),血管活性肠肽(VIP)较术前高(P<0.05),且研究组胃动素、胃泌素均较对照组高(P<0.05),VIP较对照组低(P<0.05)。术后,2组降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-17(IL-17)均较术前高(P<0.05),且研究组PCT、CRP、IL-17均较对照组低(P<0.05)。随访1年,研究组复发率(4.55%,2/44)较对照组(2.38%,1/42)差异无统计学意义(Fisher精确检验P=1.000)。结论EMR可提高消化道息肉患者息肉切除率,缩短手术时间、术后禁食时间,减少胃肠道不适情况发生,减弱炎性反应,对胃肠道激素干扰小,帮助患者尽早出院。Objective To observe the clinical efficacy of routine surgery and endoscopic mucosal resection(EMR)in the treatment of gastrointestinal polyps.Methods From April 2020 to April 2021,86 patients with gastrointestinal polyps in our hospital were divided into two groups according to the random number table method.The control group(n=42)received high-frequency resection,and the study group(n=44)received EMR.Polyp resection,perioperative indicators,hospital stay,influence of gastrointestinal function,gastrointestinal hormone levels,inflammatory factor,and recurrence after 1-year follow-up were compared.Results The en bloc resection rate(97.73%,43/44)and complete resection rate(100%,44/44)in the study group were higher than those in the control group(83.33%,35/42)and(88.10%,37/42)(P<0.05).The operation time,postoperative fasting time,and hospitalization time of the study group were shorter than those of the control group(P<0.05),the intraoperative bleeding rate and delayed bleeding rate were no significantly different compared with the control group(P>0.05).The total incidence of gastrointestinal discomfort in the study group(25.00%,11/44)was lower than that in the control group(50.00%,21/42)(P<0.05).At 24 hours after operation,motilin and gastrin in both groups were lower than those before operation(P<0.05),vasoactine intrestinal peptide(VIP)was higher than that before operation(P<0.05),and motilin and gastrin in study group were higher than those in control group(P<0.05),VIP was lower than the control group(P<0.05).After operation,procalcitonin(PCT),C-reactive protein(CRP)and interleukin-17(IL-17)in the two groups were higher than those before operation(P<0.05),and PCT,CRP and IL-17 in the study group were lower than those in the control group(P<0.05).After 1 year of follow-up,the recurrence rate of the study group(4.55%,2/44)was not significantly different from that of the control group(2.38%,1/42)(Fisher’s exact test P=1.000).Conclusion EMR can raise the polyp resection rate of patients with gastrointestinal polyp

关 键 词：内镜下黏膜切除术 消化道息肉 胃肠道功能 胃肠道激素 血管活性肠肽 

分 类 号：R472.91[医药卫生—护理学]