内镜黏膜切除术治疗结直肠息肉的效果及术后迟发性出血的相关危险因素分析  

Effect of Endoscopic Mucosal Resection in Treatment of Colorectal Polyps and Analysis on Risk Factors for Delayed Bleeding After Operation

作　　者：张科[1] 成翠娥[1] 肖龙[1] 王斌[1] Zhang Ke;Cheng Cui-e;Xiao Long;Wang Bin(Department of Gastroenterology,Changshu No.2 People's Hospital,Changshu 215500,Jiangsu Province,China)

机构地区：[1]常熟市第二人民医院消化内科,江苏常熟215500

出　　处：《中国社区医师》2023年第10期55-57,共3页Chinese Community Doctors

摘　　要：目的:探讨内镜黏膜切除术治疗结直肠息肉的效果及术后迟发性出血的相关危险因素。方法:选取2020年6月—2022年7月常熟市第二人民医院收治的156例结直肠息肉患者作为研究对象,所有患者采取内镜黏膜切除术治疗,分析治疗后临床疗效,并总结迟发性出血的单因素,通过logistic回归分析总结影响术后迟发性出血的主要原因。结果:治疗总有效率89.7%;10例术后迟发性出血患者中>60岁占比高于≤60岁,合并糖尿病、高血压占比高于无糖尿病、高血压,术中出血占比高于术中未出血,术中追加镇静药物占比高于术中未追加镇静药物,息肉直径≥0.8 mm占比高于<0.8 mm,差异有统计学意义(P<0.01);性别、术前是否服用阿司匹林等药物治疗占比比较,差异无统计学意义(P=1.000);通过logistic回归分析可见,影响术后迟发性出血的危险因素包括年龄、合并症、出血、追加镇静药物、息肉直径。结论:内镜黏膜息肉切除术对结直肠息肉治疗效果明显,但在术后应注意积极预防迟发性出血相关因素,加强对高危因素患者的管理,以预防迟发性出血,提高康复效果。Objective:To explore the effect of endoscopic mucosal resection in the treatment of colorectal polyps and the related risk factors for delayed bleeding after operation.Methods:From June 2020 to July 2022,a total of 156 patients with colorectal polyps who were admitted to Changshu No.2 People's Hospital were selected as the study subjects.All patients were treated with endoscopic mucosal resection.The clinical efficacy after treatment was analyzed.The single factor of delayed bleeding was summarized.The main reasons affecting the postoperative delayed bleeding were summarized through logistic regression analysis.Results:The overall response rate of treatment was 89.7%;Among the 10 patients with postoperative delayed bleeding,the proportion of>60 years old was higher than that of≤60 years old,the proportion of complicated diabetes mellitus and hypertension was higher than that of no diabetes mellitus and hypertension,the proportion of intraoperative bleeding was higher than that of intraoperative non-bleeding,the proportion of intraoperative additional sedative drugs was higher than that of no intraoperative additional sedative drugs,and the proportion of polyp diameter≥0.8 mm was higher than that of<0.8 mm,the differences were statistically significant(P<0.01).There was no significant difference in the gender and the proportion of preoperative aspirin and other drugs(P=1.000).Through logistic regression analysis,risk factors affecting postoperative delayed bleeding included age,complication,bleeding,additional sedative drugs,and polyp diameter.Conclusion:Endoscopic mucosal polypectomy is effective in the treatment of colorectal polyps.However,attention should be paid to the prevention of delayed bleeding related factors after surgery,and the management of patients with high risk factors should be strengthened to prevent delayed bleeding and promote recovery effect.

关 键 词：内镜黏膜切除术 结直肠息肉 迟发性出血 

分 类 号：R656[医药卫生—外科学]