内镜下结直肠息肉切除术后迟发性出血的危险因素分析

Risk factors of delayed colonoscopic post-polypectomy bleeding

目的分析结直肠息肉切除术后迟发性出血的危险因素。方法回顾性分析2014年1月至2017年5月行内镜下结直肠息肉切除术的459例患者资料，根据术后是否发生迟发性出血分为出血组与未出血组，比较2组相关因素的差异，分析迟发性出血的危险因素。结果459例患者中发生迟发性出血者27例；共切除息肉572枚，发生迟发性出血息肉42枚。单因素分析显示，患者性别（男性85.2%）、切除息肉数量（≥3枚者59.3%）、合并高脂血症（29.6%），息肉直径（≥10 mm者66.7%）、形态（有蒂81.0%）、病理类型（腺瘤型95.2%）、切除方式（EMR者90.5%）与迟发性出血显著相关（P〈0.05）。Logistic回归分析显示，患者性别、合并高脂血症，息肉数目、大小、形态为迟发性出血的独立危险因素（P〈0.05）。结论男性患者、合并高脂血症、切除≥3枚息肉、息肉直径≥10 mm、息肉有蒂为迟发性出血的独立危险因素。

ObjectiveTo analyze the risk factors of delayed post-polypectomy bleeding （DPPB） of colonoscopy.MethodsThe data of 459 patients who underwent colonoscopic polypectomy between January 2014 and May 2017 were summarized, and the risk factors of DPPB were analyzed.ResultsAmong the 459 patients, a total of 572 polyps were removed, and DPPB occurred in 27 patients with 42 polyps. Univariate analysis revealed that gender （male 85.2%）, number of polyps removed （≥3 polyps, 59.3%）, complicated with hyperlipidemia （29.6%）, polyps′ diameter （≥10 mm, 66.7%）, morphology （pedunculated, 81.0%）, pathological type （adenoma, 95.2%）, and excision method （endoscopic mucosal resection, 90.5%） were significantly correlated with DPPB （all P〈0.05）. Logistic regression analysis showed that gender, with hyperlipidemia, number of polyps removed, polyps′ size, and morphology were independent risk factors of DPPB （P〈0.05）.ConclusionThe risk factors of DPPB include male, complicated with hyperlipidemia, excision of more than 3 polyps, more than 10 mm in diameter, and pedunculated morphology.