结直肠息肉内镜下摘除术后出血的危险影响因素分析  

An Analysis on the Risk Factors Influencing Hemorrage Following Endoscopic Polypectomy for Colorectal Polyps

作　　者：程红山 CHENG Hong-shan(Yunmeng County's People's Hospital,Xiaogan,Hubei432500)

机构地区：[1]湖北省孝感市云梦县人民医院,湖北孝感432500

出　　处：《中国肛肠病杂志》2022年第5期35-37,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨影响结直肠息肉内镜下摘除术后出血的危险因素。方法:回顾2018年9月至2020年9月于我院行内镜下摘除术治疗的124例结直肠息肉患者资料,根据术后是否发生出血分为出血组和未出血组,比较2组患者一般资料(性别、年龄、高血压/高血脂/糖尿病病史)及息肉相关资料(息肉发生部位、息肉形态、大小、数量、病理类型及手术治疗方式),并进一步行多因素Logistic回归分析。结果:124例结直肠息肉患者术后出血16例,其中急性出血3例,迟发性出血13例。出血组与未出血组患者性别、年龄、糖尿病病史、息肉发生部位、息肉数量、病理类型、手术治疗方式方面比较差异均无统计学意义,P>0.05;但在高血压病史、高血脂病史、息肉形态、大小方面,2组差异有统计学意义,P<0.05。多因素Logistic回归分析显示,高血压、高血脂、息肉直径>2.0cm及息肉有蒂与结直肠息肉内镜下摘除术后出血密切相关,P<0.05。结论:影响结直肠息肉内镜下摘除术后出血的危险因素有高血压、高血脂、息肉直径>2.0cm及息肉有蒂。临床工作中,应做好术前评估,积极予以干预,降低术后出血风险。Objective To explore the risk factors influencing hemorrage following endoscopic polypectomy for colorectal polyps.Methods Reviewed the data of 124patients with colorectal polyps who had received endoscopic polypectomy in author’s hospital(2018-09-2020-09):according to with or without hemorrage,divided the 124cases into hemorrage group and no-hemorrage group;compared the patients’general materials(gender,age,hypertension/hyperlipid/DM history),as well as the polyps’relevant materials(the site,size,numbers,pathological type,and treatment pattern of polyps);then,took Logistic regression multi-variate analysis on above materials.Results In the 124cases,16suffered from postoperative bleeding(3being of acute bleeding,13of delayed one),compared to no-bleeding patients in gender,age,DM history,polyps site,polyps numbers and pathological pattern,as well as procedures there was no statistical difference(P>0.05);but in hypertension history,hyperlipid history,as well as polyps form and size there was statistical difference(P<0.05).Multi-variate logistic regression anlysis showed hypertension,hyperlipid,as well as polyps diameter>2.0cm and with petiole were closely related to postoperative bleeding(P<0.05).Conclusion The risk factors influencing hemorrage following endoscopic polypectomy for colorectal polyps include hypertension,hyperlipid,as well as polyps diameter>2.0cm and with petiole.In clinical practice it should be making preoperative evaluation better,and actively intervening it,so as to reduce the risk of postoperative bleeding.

关 键 词：内镜 结直肠息肉摘除术 术后出血 危险因素 

分 类 号：R656[医药卫生—外科学]