影响结直肠腺瘤内镜摘除术后复发因素的临床分析  

Clinical analysis of factors affecting colorectal adenoma recurrence after endoscopic resection

作　　者：刘文静 胡晓娜 季大年[3] 黄任翔[3] 保志军 LIU Wen-jing;HU Xiao-na;JI Da-nian;HUANG Ren-xiang;BAO Zhi-jun(Department of Gastroenterology,Huadong Hospital,Fudan University,Shanghai 200040,China;Endoscopy Center,Huadong H ospita l,Fudan University,Shanghai 200040,China;Shanghai Key Laboratory of Clinical Geriatric Medicine,Shanghai 200040,China)

机构地区：[1]复旦大学附属华东医院消化科,上海200040 [2]上海市老年医学临床重点实验室,上海200040 [3]复旦大学附属华东医院内镜中心,上海200040

出　　处：《复旦学报（医学版）》2018年第2期185-190,205,共7页Fudan University Journal of Medical Sciences

基　　金：上海市卫生计生系统重要薄弱学科建设计划(2015ZB0501)~~

摘　　要：目的通过分析可能影响结直肠腺瘤内镜摘除术后的复发因素,为结直肠腺瘤内镜摘除术后的定期随访提供参考。方法收集2013年1月1日至2014年12月31日在华东医院消化科住院行内镜下结直肠腺瘤摘除术且术后随访结肠镜的患者相关信息,包括性别、年龄、吸烟史、饮酒史、高血压病史、糖尿病史、脂肪肝情况、胆囊切除史、幽门螺杆菌感染情况、相关代谢指标、腺瘤个数、腺瘤大小、腺瘤部位、腺瘤病理等。通过Logistic回归分析进行单因素和多因素分析,探讨影响结直肠腺瘤内镜摘除术后复发的因素。结果共纳入283例患者,低危腺瘤复发率为39.3%,高危腺瘤复发率为56.3%,总复发率为52.7%。单因素分析发现幽门螺杆菌感染和基础腺瘤个数是结直肠腺瘤内镜摘除术后复发的危险因素(P均<0.001,OR值分别为2.802和2.789,95%CI分别为1.660~4.728和1.667~4.668),多因素分析发现幽门螺杆菌感染和基础腺瘤个数是结直肠腺瘤内镜摘除术后复发的危险因素(P均<0.001,OR值分别为3.316和2.799,95%CI分别为1.869~5.884和1.578~4.963)。结论结直肠腺瘤内镜摘除术后的复发可能与幽门螺杆菌感染和基础结直肠腺瘤的个数有关。Objective To analyze the factors that might affect the recurrence after endoscopic resection of colorectal adenoma,we aim to provide a reference for the regular follow-up of colorectal adenoma after endoscopic resection.Methods In the Department of Gastroenterology,Huadong Hospital from Jan.,2013 to Dec.,2014,patients received endoscopic resection during hospital stay and postoperative follow-up colonoscopy.We collected their information of gender,age,smoking history,drinking history,hypertension,diabetes,fatty liver,cholecystectomy history,H elicobacter p y lo r i(H.p y lo r i)infection,related metabolic indicators,number of adenoma,size of adenoma,location of adenoma and pathology of adenoma.Multivariate and univariate analysis were performed by Logistic regression analysis to explore factors influencing the recurrence risk of colorectal adenoma.Results A total of 283 cases were enrolled.The recurrence rate of low-risk and high-risk adenoma was 39.3%and 56.3%,respectively,and therate of all adenoma was 52.7%,Multivariate and univariate analysis both found that H.pyloriinfection(P<0.001,OR:3.316 and 2.802,95%C l:1.869_5.884 and 1.660_4.728)and adenoma number(P<0.001,OR:2.799 and 2.789,95%C l:1.578-4.963 and 1.667-4.668)were risk factors for colorectal adenoma recurrence after endoscopic excision.Conclusions H.pylori infection and the number of base colorectal adenoma maybe associated with colorectal adenoma recurrence.

关 键 词：结直肠腺瘤 复发 影响因素 幽门螺杆菌 回顾性研究 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]