结直肠息肉内镜下黏膜切除术后出血的危险因素分析
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Risk factors for postpolypectomy bleeding after endoscopic mucosal resection
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    摘要:

    目的:消化道出血是结直肠息肉切除术后最常见的并发症,本研究探讨结直肠息肉内镜下黏膜切除(endoscopic mucosal resection,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例未出血患者的临床资料。结果:单因素分析显示,共有5个变量对结直肠息肉EMR术后出血的影响有统计学意义,分别为男性(P=0.008)、息肉数目(≥3枚)(P=0.001)、息肉直径(≥10 mm)(P < 0.001)、息肉分布部位(右半结肠)(P=0.036)、抗栓药的使用(P=0.015)。对上述5个变量及高血压(P < 0.1)、病理类型(腺瘤)(P < 0.1)进行多变量Logistic回归分析,其中男性、息肉直径(≥10 mm)、息肉数目(≥3枚)为结直肠息肉EMR术后出血的独立危险因素(P < 0.05)。结论:男性、息肉直径(≥10 mm)、息肉数目(≥3枚)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:Alimentary tract hemorrhage is the most frequent complication after colonoscopic polypectomy. The aim of this study was to identify the risk factors for postpolypectomy bleeding(PPB)after endoscopic mucosal resection(EMR). Methods:We retrospectively reviewed the clinical data of 111 patients who experienced PPB after EMR and 176 patients who did not. Results:Univariate logistic regression analysis showed that gender(male,P=0.008),numbers of polyps removed(≥3 polyps,P=0.001),polyp’ diameter(≥10 mm,P < 0.001),location(right colon,P=0.036),use of antithrombotic drug(P=0.015)were significantly correlated with PPB. Above factors,hypertension(P < 0.1)and pathological type(adenoma,P < 0.1)were analyzed by multivariate logistic regression,and only gender(male),polyps’ diameter(≥10 mm)and numbers of polyps removed(≥3 polyps)were significantly associated with PPB after EMR. Conclusion:Gender(male),polyps’ diameter(≥10 mm)and polyp number(≥3 polyps)are significantly associated with PPB after EMR,and we should pay more attention to these factors for preventing PPB

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李培培,王宇晴,倪 永,沙林玉,于莲珍.结直肠息肉内镜下黏膜切除术后出血的危险因素分析[J].南京医科大学学报(自然科学版),2019,(3):360-364

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  • 收稿日期:2018-05-15
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  • 在线发布日期: 2019-04-01
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