摘要
目的:探讨结肠息肉内镜下切除术后迟发性出血的危险因素.方法:回顾性分析2019年1月1日～2020年12月31日在芜湖市中医医院内镜中心行结肠息肉切除的735例患者的临床资料,分析与结肠息肉术后迟发性出血相关的因素.结果:术后迟发性出血发生率为6.80％;单因素分析显示,术后迟发性出血与年龄(P=0.045)、性别(P=0.007)、术后进食时间(P＜0.001)、息肉外观(P＜0.001)、息肉直径(P=0.016)、切除息肉数量(P=0.017)、息肉有蒂(P＜0.001)、息肉分叶(P＜0.001)、钛夹夹闭方式(P＜0.001)有关;多因素Logistics回归分析显示,高龄(OR=1.03,95％CI:1.005～1.055)、术后进食时间 24～48h(OR=3.909,95％CI:2.185～6.995)、术后进食时间＞48 h(OR=7.244,95％CI:3.218～16.304)、息肉外观发红(OR=47.608,95％CI:23.117-98.042)、切除息肉数量≥ 5 枚(OR=3.999,95％CI:1.728-9.255)、息肉有蒂(OR=2.904,95％CI:1.678～5.024)均是术后出血的独立危险因素(P＜0.05).结论:高龄、男性、息肉外观发红、息肉有蒂、切除息肉数量≥5枚、术后近期进食增加结肠息肉内镜下切除术后迟发性出血风险.
Abstract
Objective:To explore the risk factors of delayed bleeding after endoscopic resection of colon polyps.Methods:The clinical data were collected from 735 patients undergone endoscopic resection of colon polyps in the Wuhu Hospital of Traditional Chinese Medicine between January 2019 and December 2020,and retrospectively analyzed for the related factors affecting delayed postoperative bleeding.Results:The incidence of delayed postoperative bleeding was 6.80％.Univariate analysis showed that delayed postoperative bleeding was involved in the patients'age(P=0.045),gender(P=0.007),polyp diameter(P=0.016),food resuming after surgery(P＜0.001),polyp appearance,polyp with pedicle,polyp lobulation and clamping mode of titanium clip(all P＜0.001).Multivariate logistics regression analysis showed that older age(OR=1.03,95％CI:1.05-1.055),the time to resume postoperative food within 24-48 hours(OR=3.909,95％CI:2.185-6.995),red polyp(OR=47.608,95％CI:23.117-98.042),number of polyps removed≥5(OR=3.999,95％CI:1.728-9.255)and polyp with pedicle(OR=2.904,95％CI:1.678-5.024)were independent risk factors for postoperative bleeding(P＜O.05).Conclusion:The risks of delayed bleeding after endoscopic resection of colon polyps are associated with older age,male gender,red polyp,polyp with pedicle,number of polyps removed ≥5 and early resuming of postoperative food.
基金项目
芜湖市医学重点专科建设项目(十四五)(2021rkx2-1)
维普
万方数据