内镜下切除大肠息肉术后迟发性出血的危险因素分析

Risk factors for delayed bleeding after endoscopic polypectomy of colorectal polyps

摘要:

探讨大肠息肉内镜下切除术后迟发性出血（DPPB）的危险因素。方法 对2014年7月-2017年7月在湖北省肿瘤医院行内镜下切除术治疗的大肠息肉1 098例患者的临床资料进行回顾性分析，研究术后DPPB的危险因素。结果 纳入研究的患者1 098例，治疗息肉2 169枚，18例患者（1.6%）出现术后DPPB，单因素分析发现患者有高血压病史（P =0.007）、息肉直径≥10 mm（P =0.009）、右半结肠息肉（P =0.015）、腺瘤性息肉（P =0.045）是DPPB的危险因素。多因素分析显示高血压病史（P =0.002，OR=4.654，95%CI：1.755～12.343）、息肉直径≥10 mm（P =0.009，OR=3.637，95%CI：1.390～9.517）、右半结肠息肉（P =0.016，OR=3.656，95%CI：1.273～10.504）是内镜下切除术后DPPB的独立危险因素。结论 有高血压病史、息肉直径≥10 mm、息肉位于右半结肠的患者内镜下切除术后易出现迟发性出血，建议采取措施进行预防性止血。

Abstract:

Abstract: Objective To analyze risk factors for delayed postpolypectomy bleeding (DPPB) of colorectal polyps. Methods We reviewed 1 098 patients (2 169 polyps) who accepted endoscopic polypectomy from July 2014 to July 2017. Evaluate the risk factors for DPPB. Results DPPB occurred in 18 (1.6%) cases. Univariate analysis revealed that history of hypertension (P = 0.007), polyp size ≥10 mm (P = 0.009), right hemicolon location (P = 0.015) and adenomatous polyp (P = 0.045) were risk factors for DPPB. Multivariate logistic regression analysis revealed that history of hypertension (P = 0.002, OR = 4.654, 95%CI: 1.755 ~ 12.343), polyp size ≥10 mm (P = 0.009, OR = 3.637, 95%CI: 1.390 ~ 9.517), location in the right hemicolon (P = 0.016, OR = 3.656, 95%CI: 1.273 ~ 10.504) were independent risk factors for DPPB. Conclusion Patients with history of hypertension, polyp size ≥10 mm, polyp location in the right hemicolon are prone to DPPB. We should take effective measure to prevent DPPB.