内镜下黏膜切除术与高频电凝切除术治疗胃息肉的临床效果对比  

Comparison on the Clinical Effects Between Endoscopic Mucosal Resection and High-Frequency Electrocoagulation Resection for the Treatment of Gastric Polyps

作　　者：李倩倩 张毛 杨文义 LI Qianqian;ZHANG Mao;YANG Wenyi(Department of Gastroenterology,Nanyang Central Hospital,Nanyang 473000,China;Department of Gastroenterology,the First Affiliated Hospital ofHe'nan University,Kaifeng 475001,China)

机构地区：[1]南阳市中心医院消化内科,河南南阳473000 [2]河南大学第一附属医院消化内科,河南开封475001

出　　处：《临床医学工程》2025年第3期245-248,共4页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目“内镜下不同术式对胃黏膜下肿瘤的治疗效果分析”(LHGJ20190531)。

摘　　要：目的 对比内镜下黏膜切除术(EMR)与高频电凝切除术治疗胃息肉的临床效果。方法 选取2022年1月至2024年6月南阳市中心医院收治的胃息肉患者84例,随机分为A组(42例)和B组(42例)。A组行EMR治疗,B组行高频电凝切除术治疗。比较两组的手术相关指标、应激反应指标、炎性因子以及术后并发症。结果 两组的手术时间对比,差异无统计学意义(P>0.05);A组的息肉完整切除率高于B组,失血量少于B组,息肉切除时间、住院时间均短于B组(P <0.05)。术后1 d,两组的应激反应指标(5-HT、 Cor、 NE)水平均较术前升高,但A组的5-HT、 Cor、 NE水平均低于B组(P <0.05)。术后1 d,两组的炎性因子(CRP、 IL-17、 PCT、 IL-6)水平均较术前升高,但A组的CRP、 IL-17、 PCT、 IL-6水平均低于B组(P <0.05)。A组的术后并发症发生率为4.76%,低于B组的21.43%(P <0.05)。结论 与高频电凝切除术相比,EMR治疗胃息肉的效果更佳,手术创伤更小,术后并发症更少,引起的应激反应、炎性反应更轻,患者术后恢复更快。Objective To compare the clinical effects of endoscopic mucosal resection(EMR)and high-frequency electrocoagulation resection for the treatment of gastric polyps.Methods 84 patients with gastric polyps admitted to Nanyang Central Hospital from January 2022 to June 2024 were selected and randomly divided into group A(42 cases)and group B(42 cases).Group A was treated with EMR,while group B was treated with high-frequency electrocoagulation resection.The surgical-related indicators,stress response markers,inflammatory factors,and postoperative complications were compared between the two groups.Results No statistically significant difference was found in the operative time between the two groups(P>0.05).The complete resection rate of polyps in group A was higher than that in group B,the blood loss amount was less than that in group B,and the polyp resection time and hospitalization time were shorter than those in group B(P<0.05).1 day after surgery,the levels of stress response markers(5-HT,Cor,NE)in both groups were higher than those before surgery,while the levels of 5-HT,Cor,and NE in group A were lower than those in group B(P<0.05).1 day after surgery,the levels of inflammatory factors(CRP,IL-17,PCT,IL-6)in both groups were higher than those before surgery,while the levels of CRP,IL-17,PCT,and IL-6 in group A were lower than those in group B(P<0.05).The incidence of postoperative complications in group A was 4.76%,lower than 21.43%in group B(P<0.05).Conclusions Compared with high-frequency electrocoagulation resection,EMR is more effective for the treatment of gastric polyps,with less surgical trauma,fewer postoperative complications,milder stress response and inflammatory response,and faster postoperative recovery of patients.

关 键 词：胃息肉 内镜下黏膜切除术 高频电凝切除术 应激反应 炎性因子 并发症 

分 类 号：R573.9[医药卫生—消化系统]