留置金属夹预防结肠小息肉内镜黏膜切除术后迟发性出血的价值研究  

Prophylactic effect of clipping after endoscopic mucosal resection of small colorectal polyps on delayed bleeding

作　　者：郭雨栋[1] 唐秀芬[1] Guo Yudong;Tang Xiufen(Department of Gastroenterology,Digestive Disease Hospital,Heilongjiang Provincial Hospital,Harbin 150000,China)

机构地区：[1]黑龙江省医院消化病院,哈尔滨150000

出　　处：《中华消化内镜杂志》2021年第11期907-911,共5页Chinese Journal of Digestive Endoscopy

基　　金：黑龙江省卫生健康委员会科技计划(2019-125)。

摘　　要：目的探讨直径10 mm以下无蒂结直肠息肉行内镜黏膜切除术(endoscopic mucosal resection,EMR)后,留置金属夹对于预防息肉切除术后迟发性出血(delayed post-polypectomy bleeding,DPPB)的价值。方法将2017年1月-2019年12月于黑龙江省医院消化病院因直径10 mm以下无蒂结直肠息肉拟行EMR的患者,根据计算机产生的随机序列表分为术后留置金属夹组(A组)和未留置金属夹组(B组),对比两组术后迟发性出血的相关情况。结果共纳入1838例患者,A组912例,B组926例。两组术后迟发性出血发生率分别为1.00%(9/912)和1.10%(10/926),组间差异无统计学意义(χ^(2)=0.039,P>0.05)。两组出血息肉个数比例为0.44%(9/2029)和0.49%(10/2025),组间差异无统计学意义(χ^(2)=0.055,P>0.05)。6~9 mm息肉(OR=11.032,95%CI:2.545~47.821,P<0.05)是无蒂结直肠息肉EMR术后迟发性出血的独立危险因素。结论10 mm以下无蒂结直肠息肉EMR治疗后,留置金属夹并未显著降低术后迟发性出血的风险。Objective To explore the prophylactie efeet of clipping after endoscopie mucosal resection(EMR)of sesile colorectal polyps of diameter below 10 mm on delayed post-polypectomy bleeding(DPPB).Methods Patients with sessile colorectal polyps of below 10 mm undergoing EMR from January 2017 to December 2019 in Digestive Disease Hospital,Heilongiang Provincial Hospital were randomly divided into the elipping group(group A)and the nn-lipping group(group B)by random number table,and DPPB rates of both groups were compared.Results A total of I 838 patients were included,912 patients in group A and 926 patients in group B.The ineidences of DPPB were 1.00%(9/912)and 1.10%(10/926)respetively,with no signifcant difference(χ^(2)=0.039,P>0.05).The proportion of bleeding polyps were 0.44%(9/2029)and 0.49%(10/2025)respectively,with no signifcant diference(χ^(2)=0.055,P>0.05).Polyp of 6-9 mm(OR=1I.032,95%CI:2.545-47.821,P<0.05)was the independent risk factor for delayed bleeding in small sessile coloretal polyps afer EMR.Conclusion Prophylactie clipping for ssile colorectal polyps below 10 mm afer EMR may not significanly reduce the risk of DPPB.

关 键 词：结肠息肉 内镜下粘膜切除术 出血 金属夹 

分 类 号：R735.34[医药卫生—肿瘤]