摘要
目的 研究结肠及直肠息肉内镜下黏膜切除术(EMR)术中应用钛夹的效果及出血风险.方法 选取2018年1月~2019年12月安徽省滁州市第一人民医院消化内科收治的结肠及直肠息肉患者50例作为研究对象,按照随机数表法将其分为观察组和对照组,每组25例.对照组行常规EMR,观察组在对照组的基础上应用金属钛夹.比较两组手术时间、术中出血量、肠鸣音恢复时间、排便疼痛视觉模拟(VAS)评分、排便困难评分、二次手术率及住院期间出血事件及并发症发生情况;比较两组术前及术后12h血清皮质醇(COR)、肾上腺素(E)、去甲肾上腺素(NE)、多巴胺(DA)水平.结果 观察组术中出血量、VAS评分及二次手术率均明显低于对照组,差异有统计学意义(P<0.05).与术前比较,两组术后COR、E、NE、DA升高,差异有统计学意义(P<0.05).两组间COR、E、DA比较,差异无统计学意义(P>0.05),观察组术后NE低于对照组,差异有统计学意义(P<0.05).观察组出血发生率、并发症总发生率明显低于对照组,差异均有统计学意义(均P< 0.05).结论 结肠及直肠息肉EMR术中应用金属钛夹可较好的减轻术中及术后出血风险,能够降低术后并发症的发生率,有较高的临床意义.
Objective To study the effect and bleeding risk of titanium clips in endoscopic mucosal resection(EMR)of colorectal polyps.Methods From January 2018 to December 2019,50 patients with colonic and rectal polyps who admitted to the Department of Gastroenterology,the First People′s Hospital of Chuzhou were selected as the study objects.They were divided into the observation group and the control group according to the random number table method,with 25 cases in each group.Routine EMR was performed in the control group,while titanium clip was used in the observation group on the basis of the control group.The operation time,intraoperative bleeding volume,recovery time of bowel sounds,visual analogue scale(VAS)score of defecation pain,score of defecation difficulty,secondary operation rate and complications during hospitalization were compared between the two groups.The levels of cortisol(COR),adrenaline(E),noradrenaline(NE)and dopamine(DA)were compared before and 12 h after operation.Results The amount of bleeding,VAS score and the number of secondary operations in the observation group were significantly lower than those in the control group(P<0.05).Compared with pre-operation,the postoperative COR,E,NE and DA of the two groups were increased,and the difference was statistically significant(P<0.05).There was no statistically significant difference in COR,E,DA between the two groups(P>0.05).The postoperative NE of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).The incidence of bleeding and complications in the observation group were significantly lower than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion The application of titanium clip in EMR of colon and rectum polyp can reduce the risk of bleeding and the incidence of postoperative complications.
作者
顾世松
吕珂
朱克东
GU Shisong;LYU Ke;ZHU Kedong(Department of Gastroenterology,the First People′s Hospital of Chuzhou,Anhui Province,Chuzhou 239000,China)
出处
《中国医药导报》
CAS
2020年第19期85-88,共4页
China Medical Herald
基金
安徽省杰出青年学者自然科学基金项目(1808085J28)。
关键词
结肠息肉
内镜下黏膜切除术
钛夹止血
Colonic polyp
Endoscopic mucosal resection
Hemostasis with titanium clip
作者简介
通讯作者:朱克东。
