结直肠息肉经内镜摘除术后并发出血的危险因素分析

Analysis of the risk factors of bleeding after endoscopic resection of colorectal polyps

摘要:

目的?分析结直肠息肉经内镜摘除术后并发出血的危险因素。方法?以该院收治的342例行内镜摘除术治疗的结直肠息肉患者为研究对象，统计该组患者经内镜摘除术后并发出血的发生率。并将该组患者分为并发出血组和未并发出血组，以术后并发出血为因变量，以可能诱发患者术后出血的相关因素（性别、年龄、合并糖尿病、合并高血压、高血脂史、饮酒史、息肉发生位置、息肉病理分型、息肉大小、息肉形态和息肉数量）为自变量，先进行单因素回归分析，再运用Logistic回归分析工具进行多因素分析。结果?该组342例患者术后并发出血的发生率为7.60%（26/342）。单因素分析结果显示，并发出血组患者合并高血压者比例高于未并发者（P <0.05），合并高血脂史者比例高于未并发者（P <0.05），息肉直径>2.0 cm者比例高于未并发者（P <0.05），息肉形态有蒂息肉者比例高于未并发者（P <0.05）。多因素分析结果显示，高血压、合并高血脂、息肉直径>2.0 cm、息肉形态有蒂息肉均为结直肠息肉经内镜摘除术后并发出血的危险因素（P <0.05）。结论?结直肠息肉经内镜摘除术后并发出血的危险因素包括高血压、合并高血脂、息肉直径>2.0 cm、息肉形态为有蒂息肉。

Abstract:

Objective?To analyze the risk factors of bleeding after endoscopic resection of colorectal polyps.?Methods?342 cases of colorectal polyps treated by endoscopic surgery in our hospital were taken as the research objects. The incidence of bleeding after endoscopic surgery was statistically studied. All the patients were divided into bleeding group and no hemorrhage group, with postoperative bleeding as the dependent variable, and related factors which may be induced postoperative bleeding (gender, age, diabetes mellitus, with hypertension and hyperlipidemia history, drinking history, polyp occurrence location, polyp pathology type, polyp size, morphology of colonic polyps, polyp number) as the independent variable to make advanced single factor regression analysis. Then using the logistic regression analysis tool for multivariate analysis.?Results?The incidence of postoperative bleeding was 7.60% (26/342) in 342 patients. Single factor analysis showed that the bleeding in the proportion of patients with hypertension was higher than that of without complication (P < 0.05), with history of high blood lipid ratio is higher than that of without complication (P < 0.05) and polyp diameter >2.0 percentage higher than that without complication (P < 0.05) and polyp morphology with pedunculated polyps proportion is higher than that without complication (P < 0.05). Multivariate analysis showed that the risk factors for bleeding after endoscopic resection of colorectal polyps were high blood pressure, high blood fat, polyp diameter >2.0 cm, and polyps were the risk factors of postoperative hemorrhage (P < 0.05).?Conclusion?The risk factors of bleeding after endoscopic resection of colorectal polyps, including hypertension, high blood fat, polyp diameter >2.0 cm, polyp morphology of pedicle polyps.