内科

目的评估胃镜下高频电切术联合氩离子凝固术（APC）治疗消化道息肉的临床疗效，及其对患者术后胃肠功能恢复和炎性因子水平的影响。方法本研究采用回顾性队列研究设计。选择2024年1月至12月收治的81例符合条件的消化道息肉患者，并根据实际接受的手术方案将患者分为两组：A组（n=39）行单纯胃镜下高频电切术，B组（n=42）行胃镜下高频电切术联合APC。比较两组患者的临床疗效、手术相关指标（手术时间、术中出血量、住院时间）、术后胃肠功能恢复指标（首次排气时间、肠鸣音恢复时间、首次排便时间）及术前、术后14 d的血清炎性因子水平［白细胞介素（IL）-6、C反应蛋白（CRP）、肿瘤坏死因子（TNF）-α］，并对比两组并发症发生情况。结果 B组总有效率高于A组（P<0.05）。两组手术时间差异无统计学意义（P>0.05），但B组术中出血量少于A组，住院时间短于A组（均P<0.05）；B组术后首次排气时间、肠鸣音恢复时间及首次排便时间均短于A组（均P<0.05）。术后14 d，两组患者血清IL-6、CRP、TNF-α水平均升高（均P<0.05），但B组上述炎性因子水平均低于A组（均P<0.05）。B组并发症发生率低于A组，但差异无统计学意义（P>0.05）。结论胃镜下高频电切术联合APC治疗消化道息肉可显著提升临床疗效，促进术后胃肠功能早期恢复，并有效减轻全身炎症反应，缩短住院时间。

Objective To evaluate the clinical efficacy of high-frequency electrotomy combined with argon plasma coagulation (APC) under gastroscopy in the treatment of gastrointestinal polyps, as well as its impact on postoperative recovery of gastrointestinal function and inflammatory factor levels in patients. Methods This study employed a retrospective cohort design. Eighty one eligible patients with gastrointestinal polyps admitted between January and December 2024 were selected and divided into two groups based on the actual surgical protocol they received: Group A (n=39) underwent high-frequency electrotomy under gastroscopy alone, and Group B (n=42) underwent high-frequency electrotomy combined with APC under gastroscopy. The clinical efficacy, surgery-related indicators (operation time, intraoperative blood loss, length of hospital stay), postoperative gastrointestinal function recovery indicators (time to first flatus, time to bowel sound recovery, and time to first defecation), serum inflammatory factor levels (interleukin [IL]-6, C-reactive protein [CRP], and tumor necrosis factor [TNF]-α) measured preoperatively and 14 days postoperatively, and the incidence of complications were compared between the two groups. Results The total effective rate was higher in Group B than in Group A (P<0.05). There was no statistically significant difference in operation time between the two groups (P>0.05), but intraoperative blood loss was less and the length of hospital stay was shorter in Group B compared to Group A (all P<0.05); the postoperative time to first flatus, time to bowel sound recovery, and time to first defecation were shorter in Group B than in Group A (all P<0.05). Fourteen days postoperatively, serum levels of IL-6, CRP, and TNF-α increased in both groups (all P<0.05), but the levels of the above inflammatory factors were lower in Group B than in Group A (all P<0.05). The complication rate was lower in Group B than in Group A, but the difference was not statistically significant (P>0.05). Conclusion high-frequency electrotomy combined with APC under gastroscopy can significantly improve clinical efficacy, promote early postoperative recovery of gastrointestinal function, effectively alleviate systemic inflammatory response, and shorten the length of hospital stay in the treatment of gastrointestinal polyps.