结直肠息肉内镜下黏膜切除术后出血的相关因素分析
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南京医科大学第一附属医院消化科

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Risk factors for postpolypectomy bleeding after Endoscopic Mucosal Resection
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    摘要:

    目的:结直肠息肉内镜下黏膜切除术(EMR)术后出血的相关危险因素。方法:回顾性分析111例结直肠息肉EMR术后出血的患者和176例未出现出血的患者的临床资料。结果:单因素结果分析,共有5个变量对结直肠息肉EMR术后出血的影响具有统计学意义,分别为性别(男)(P=0.008)、息肉数目(P=0.001)、息肉直径≥10mm(P=0.000)、息肉分布部位(右半结肠)(P=0.036)、用抗栓药(P=0.015)。对单因素筛选出的5个变量及高血压(P<0.1)、腺瘤性息肉(P<0.1)进行多变量Logistic回归分析,其中,性别(男)、息肉直径≥10mm、息肉数目为结直肠息肉EMR术后出血的独立危险因素(P<0.05)。结论:性别(男)、息肉直径≥10mm、息肉数目为EMR息肉切除术后出血的独立危险因素,临床上应多加注意,以预防术后出血的发生。

    Abstract:

    Objective:Postpolypectomy bleeding(PPB) is the most frequent complication after colonoscopic polypectomy.The aim of this study was to identify the risk factors for post-polypectomy bleeding after endoscopic mucosal resection (EMR) Methods: We retrospectively reviewed the clinical data of 111 patients who experienced postpolypectomy bleeding (PPB) after EMR with 176 patients who did not. Patient-related and polyp-related variables were evaluated as potential PPB factors.Results: Univariate logistic regression analysis showed gender (male,p=0.008), numbers of polyps removed(≥3 polyps,p=0.001), polyp’ daimeter (≥10 mm,p=0.000), location(right colon,p= 0.036), use of antithrombotic drug (p=0.015) were significantly correlated with PPB.Performed In the aboved factors,hypertension(P<0.1) and pathological type (adenoma,P<0.1),multivariate logistic regression analysis showed that only gender (male) ,polyps’ diameter(≥10 mm) and numbers of polyps removed(≥3 polyps) were significantly associated with PPB after EMR.Conclusions:Gender (male) ,polyps’ diameter(≥10mm) and polyp number(≥3 polyps) are significantly associated with PPB after EMR,we should pay more attention on these factors to prevent post-polypectomy bleeding.

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  • 收稿日期:2018-05-15
  • 最后修改日期:2018-10-30
  • 录用日期:2019-03-04
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