内镜下切除大肠息肉术后迟发性出血的危险因素分析  

Risk factors for delayed bleeding after endoscopic polypectomy of colorectal polyps

作　　者：刘苗 王洪波[1] 陈清波[1] 徐明垚[1] 伍叶梅 Miao Liu;Hong-bo Wang;Qing-bo Chen;Ming-yao Xu;Ye-mei Wu(Department of Endoscopy,Hubei Cancer Hospital,Wuhan,Hubei 430079,China)

机构地区：[1]湖北省肿瘤医院内镜科,湖北武汉430079

出　　处：《中国内镜杂志》2018年第4期56-60,共5页China Journal of Endoscopy

摘　　要：目的探讨大肠息肉内镜下切除术后迟发性出血(DPPB)的危险因素。方法对2014年7月-2017年7月在湖北省肿瘤医院行内镜下切除术治疗的大肠息肉1 098例患者的临床资料进行回顾性分析,研究术后DPPB的危险因素。结果纳入研究的患者1 098例,治疗息肉2 169枚,18例患者(1.6%)出现术后DPPB,单因素分析发现患者有高血压病史(P=0.007)、息肉直径≥10 mm(P=0.009)、右半结肠息肉(P=0.015)、腺瘤性息肉(P=0.045)是DPPB的危险因素。多因素分析显示高血压病史(P=0.002,O■=4.654,95%CI:1.755~12.343)、息肉直径≥10 mm(P=0.009,O■=3.637,95%CI:1.390~9.517)、右半结肠息肉(P=0.016,O■=3.656,95%CI:1.273~10.504)是内镜下切除术后DPPB的独立危险因素。结论有高血压病史、息肉直径≥10 mm、息肉位于右半结肠的患者内镜下切除术后易出现迟发性出血,建议采取措施进行预防性止血。Objective To analyze risk factors for delayed postpolypectomy bleeding(DPPB)of colorectal polyps.Methods We reviewed 1 098 patients(2 169 polyps)who accepted endoscopic polypectomy from July 2014 to July 2017.Evaluate the risk factors for DPPB.Results DPPB occurred in 18(1.6%)cases.Univariate analysis revealed that history of hypertension(P=0.007),polyp size≥10 mm(P=0.009),right hemicolon location(P=0.015)and adenomatous polyp(P=0.045)were risk factors for DPPB.Multivariate logistic regression analysis revealed that history of hypertension(P=0.002,OR^=4.654,95%CI:1.755~12.343),polyp size≥10 mm(P=0.009,OR^=3.637,95%CI:1.390~9.517),location in the right hemicolon(P=0.016,OR^=3.656,95%CI:1.273~10.504)were independent risk factors for DPPB.Conclusion Patients with history of hypertension,polyp size≥10 mm,polyp location in the right hemicolon are prone to DPPB.We should take effective measure to prevent DPPB.

关 键 词：大肠息肉 内镜下切除术 迟发性出血 

分 类 号：R619[医药卫生—外科学]