中国医药指南

目的 探讨老年胃肠息肉患者经消化内镜辅助的高频电刀手术对其胃肠道功能、氧化应激的影响。方法 选取2024年1月至2024年12月期间，在德化县医院就诊胃肠息肉老年患者90例作为观察对象，通过运用随机数字表法对患者进行分组，设置对照组与观察组，组内均有45例患者。对照组采取常规电凝结合高频电刀手术治疗，观察组采取消化内镜下高频电刀手术治疗，评价患者手术治疗情况、手术前后胃肠道功能及氧化应激反应指标变化、术后并发症情况。结果 通过对两组患者实施干预后的各项观察指标进行统计，观察组手术、术后排气、住院总时长等时间指标均相对低于对照组（P<0.05），且术中出血量、术后2 h疼痛评分均相对低于对照组（P<0.05）；术后1周患者胃泌素（GAS）、胃动素（MOT）较术前降低，且观察组高于对照组（P<0.05），术后1周血管活性肠钛（VIT）较术前升高，且观察组低于对照组（P<0.05）；术后1周患者5-羟色胺（5-HT）、丙二醛（MDA）较术前升高，且观察组低于对照组（P<0.05），术后1周谷胱甘肽过氧化物酶（GSH-Px）、总抗氧化能力（T-AOC）较术前降低，且观察组相关指标均高于对照组患者（P<0.05）；统计观察组患者的术后并发症总发生率为4.44%，其相比于对照组发生率22.22%相对较低（P<0.05）。结论 消化内镜下高频电刀手术方式干预胃肠息肉的老年患者，具备创伤小、出血少、恢复快且并发症少等诸多优点，分析原因可能与手术对息肉切除满意及实施过程对胃肠道功能、氧化应激反应影响小相关。

Objective To investigate the effects of high-frequency electrosurgical operation assisted by digestive endoscope on gastrointestinal function and oxidative stress in elderly patients with gastrointestinal polyps. Methods A total of 90 elderly patients with gastrointestinal polyps treated in Dehua County Hospital from January 2024 to December 2024 were selected as the observation objects. The patients were divided into groups by using random number table method, and the control group and observation group were set up, with45 patients in each group. The control group was treated with conventional electrocoagulation combined with high-frequency electrotome surgery, and the observation group was treated with high-frequency electrotome surgery under digestive endoscope. The surgical treatment,gastrointestinal function and oxidative stress index changes before and after surgery, and postoperative complications were evaluated.Results After the intervention, the observation group was lower than the control group in terms of time indexes such as surgery, postoperative exhaustion, and total length of hospitalization(P<0.05), and the intraoperative blood loss and 2 hours postoperative pain score were lower than the control group(P<0.05). Gastrin(GAS) and motilin(MOT) were decreased 1 week after surgery, and the vasoactive intestinal titanium(VIT) was increased 1 week after surgery, and the observation group was better than the control group(P<0.05). Serotonin(5-HT)and malondialdehyde(MDA) were elevated in patients at 1 week postoperatively compared to preoperatively, the observation group was lower than the control group(P<0.05). The serum glutathione peroxidase(GSH-Px) level and total antioxidant capacity(T-AOC) of the observation group were lower than those of the control group 1 week after surgery(P<0.05). The total incidence of postoperative complications in the observation group was 4.44% lower than that in the control group(22.22%)(P<0.05). Conclusions Endoscopic high-frequency electrosurgical intervention in elderly patients with gastrointestinal polyps has many advantages, such as less trauma, less bleeding, faster recovery and fewer complications, which may be related to the satisfaction of polyp removal and the small impact of the implementation process on gastrointestinal function and oxidative stress reaction.