内科

目的探讨术前应用肌松药间苯三酚对结肠息肉内镜切除术患者出血量及疼痛因子表达的影响。方法选择2015年1月至2018年1月在我院行结肠息肉内镜切除术治疗的患者120例（息肉140枚）为研究对象，采用随机数字表法分为观察组和对照组，每组60例。对照组患者给予盐酸右美托咪定注射液麻醉，观察组患者给予右美托咪定联合间苯三酚注射液麻醉，由同一组医师对两组患者行常规结肠息肉内镜切除术。比较两组患者的手术时间及术中、术后出血量；比较两组患者手术前后的血清应激疼痛因子水平及术后不良反应发生情况。结果两组患者的手术时间比较差异无统计学意义（P＞0.05）；观察组患者的术中、术后出血量均显著少于对照组，差异有统计学意义（P＜0.05）。术前，两组患者的血清P物质（SP）、神经肽Y（NPY）、前列腺素E2（PGE2）、神经生长因子（NGF）水平比较差异无统计学意义（P＞0.05）；术后，观察组患者的SP、NPY、PGE2水平均明显低于对照组（P＜0.05），两组患者的NGF水平比较差异无统计学意义（P＞0.05）。围手术期间，两组患者的不良反应发生率比较差异无统计学意义（P＞0.05）。结论术前使用肌松药间苯三酚，可减少结肠息肉内镜切除术患者术中、术后的出血量，降低疼痛因子表达水平，但不增加不良反应。

ObjectiveTo investigate the effect of preoperative application of muscle relaxant phloroglucinol on bleeding volume and pain factor expression in patients underwent colon polyps endoscopic resection. MethodsA total of 120 patients (140 polyps) underwent colonic polypectomy by endoscope in our hospital from January 2015 to January 2018 were selected as the research subjects, and were divided into observation group and control group by random number table method, with 60 cases in each group. Patients in the control group were anesthetized with dexmedetomidine hydrochloride injection, whereas patients in the observation group were anesthetized with dexmedetomidine combined with phloroglucinol injection. The conventional colon polyps endoscopic resection was performed by the same physicians team. The operation time, intraoperative and postoperative bleeding volume were compared between the two groups. The serum stress and pain factor levels, and the postoperative prevalence of adverse reactions were compared between the two groups. ResultsThere was no statistically significant difference in the operation time between the two groups (P＞0.05). The intraoperative and postoperative bleeding volume of the observation group were significantly less than those of the control group, with the statistically significant differences (P＜0.05). Before operation, there were no statistically significant differences in serum substance P (SP), neuropeptide Y (NPY), prostaglandin E2 (PGE2), and nerve growth factor (NGF) levels between the two groups (P＞0.05); after operation, the levels of SP, NPY, and PGE2 in the observation group were significantly lower than those in the control group (P＜0.05). There was no statistically significant difference in the NGF level between the two groups (P＞0.05). During the perioperative period, there was no statistically significant difference in the incidence of adverse reactions between the two groups (P＞0.05). ConclusionPreoperative application of muscle relaxant phloroglucinol can reduce intraoperative and postoperative bleeding volume, and decrease pain factor expression level in patients underwent colon polyps endoscopic resection, but it does not increase adverse reactions.