结直肠息肉内镜下切除术后迟发性出血的危险因素分析  

Analysis of risk factors for delayed post-polypectomy bleeding after endoscopic resection of colorectal polyps

作　　者：邹傲[1] 郭海[1] 李曦[1] 王俊萍[1] 杨硕 ZOU Ao;GUO Hai;LI Xi;WANG Junping;YANG Shuo(Department of Gastroenterology,Shenzhen Hospital,Peking University,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院消化内科,广东深圳518036

出　　处：《胃肠病学和肝病学杂志》2025年第4期533-537,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析结直肠息肉内镜下切除术后迟发性出血(delayed post-polypectomy bleeding,DPPB)的危险因素。方法回顾性分析2020年1月至2023年1月北京大学深圳医院共收治9016例结直肠息肉内镜下切除术患者的临床资料,将其中192例患者作为临床研究对象,总结结直肠息肉内镜下切除术后DPPB的危险因素。结果有48例(0.5%)患者出现术后迟发性出血,DPPB与患者、息肉、医源三方面因素均有关,性别(男性)、年龄(≥50岁)、息肉位置(左半结肠)、大小(直径5~10 mm)、切除数量(≥3枚)、形态(有蒂)、病理(腺瘤)、术者经验(5~10年)及手术方式(EMR术式)与DPPB显著相关(P<0.05)。结论患者的性别、年龄、息肉因素及手术方式与结直肠息肉内镜下切除术后迟发性出血关系密切,术前充分评估这些风险因素,并讨论实用的干预措施,有助于减少DPPB的发生和提高患者安全。Objective To analyze the risk factors of delayed post-polypectomy bleeding(DPPB)after endoscopic resection of colorectal polyps.Methods The clinical data of 9016 patients with endoscopic resection of colorectal polyps were admitted to Shenzhen Hospital,Peking University,and 192 of them were taken as clinical study objects from Jan.2020 to Jan.2023.The clinical data was retrospectively analyzed and summarize the risk factors of DPPB after endoscopic resection of colorectal polyps.Results There were 48 patients with delayed post-operative bleeding,the incidence was 0.5%.DPPB was related to patients,polyp and iatrogenic factors.Gender(male),age(over 50 years old),polyp location(left half colon),size(diameter 5-10 mm),number of polyps removed(≥3),morphology(pedicle),pathology(adenoma),operator experience(5-10 years)and surgical method(EMR)were significantly correlated with DPPB(P<0.05).Conclusion The gender,age,polyp factors and surgical methods of patients are closely related to delayed bleeding after endoscopic resection of colorectal polyps.Fully assessing these risk factors before surgery and discussing practical interventions are helpful to reduce the occurrence of DPPB and improve patients′safety.

关 键 词：迟发性出血 风险因素 内镜切除术 结直肠息肉 止血夹 

分 类 号：R574[医药卫生—消化系统]