摘要
目的探讨结直肠息肉内镜切除术后发生迟发性出血的危险因素。方法回顾性分析2010年1月至2015年12月在浙江大学医学院附属第一医院内镜中心行结直肠息肉切除术的3171例患者的临床资料,分析术后发生迟发性出血的危险因素。结果结直肠息肉内镜切除术后迟发性出血发生率为2.30%。右半结肠息肉(OR=1.83,95%CI:1.26~2.71)、直肠息肉(OR=1.58,95%CI:1.24~1.67)、息肉≥1cm(OR=3.78,95%CI:2.351~5.692)、术中出血(OR=4.37,95%CI:3.192~7.342)、手术方式为内镜下黏膜切除术(OR=1.73,95%CI:1.09~2.21)或内镜下黏膜剥离术(OR=2.87,95%CI:1.86~3.14)、患有高血压(OR=4.72,95%CI:2.63~7.27)或高脂血症(OR=2.26,95%CI:1.305~3.524)等基础疾病是结直肠息肉内镜切除术后发生迟发性出血的独立危险因素(均P<0.05)。结论对于息肉≥1cm、术中出血、息肉位置在直肠或右半结肠、患有高血压或高脂血症基础疾病、手术方式采取内镜下黏膜切除术或内镜下黏膜剥离术的患者,临床医生应高度警惕术后发生迟发性出血的风险。
Objective To analyze the risk factors of colorectal delayed post-polypectomy bleeding(DPPB).Methods The clinical data of 3171 patients undergoing endoscopic colorectal polypectomy in the first affiliated hospital of Zhejiang university school of medicine from January 2010 to December 2015 were retrospectively reviewed.The risk factor related to DPPB were analyzed.Results In this study,the incidence of DPPB was 2.3%.The right colonic polyp(OR=1.83,95%CI:1.26~2.71),rectal polyp(OR=1.58,95%CI:1.24~1.67),polyp size≥1cm(OR=3.78,95%CI:2.351~5.692),intraoperative bleeding(OR=4.372,95%CI:3.192~7.342),endoscopic mucosal resection(EMR)(OR=1.73,95%CI:1.09~2.21)and endoscopic submucosal dissection(ESD)(OR=2.87,95%CI:1.86~3.14),hypertension(OR=4.72,95%CI:2.63~7.27),hyperlipidemia(OR=2.26,95%CI:1.305~3.524)were the risk factors of DPPB.Conclusion For patients with rectal or right colonic polyp and the polyp size≥1cm,and for those with underlying hypertension and hyperlipidemia,and those undergoing EMR or ESD and with intraoperative hemorrhage,clinicians should be aware of the risk of delayed colorectal bleeding after endoscopic polypectomy.
作者
阙扬铭
季峰
朱华丽
周辛欣
QUE Yangming;JI Feng;ZHU Huali(Department of Gastroenterology,the First Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310003,China)
出处
《浙江医学》
CAS
2020年第7期713-716,共4页
Zhejiang Medical Journal
关键词
结直肠息肉
迟发性出血
危险因素
Colorectal polyp
Delayed post-polypectomy bleeding
Risk factors
