结肠息肉切除术后迟发性出血的危险因素

Risk Factors of Post-polypectomy Delayed Hemorrhage

【目的】分析结肠息肉切除术后发生迟发性出血的危险因素。【方法】搜集中山大学附属第三医院2010年1月到2018年12月的患者进行回顾性研究,其中发生迟发性出血的106例患者为出血组,未发生出血的3856例患者为对照组,应用Logistic回归模型,筛选息肉切除术后出血的危险因素。【结果】纳入研究的3962例患者中,106例发生术后迟发性出血,出血构成比为2.68%,89.6%的迟发性出血发生在术后3d以内。Logistic回归分析表明息肉大小、合并高血压、合并慢性肾病、阿司匹林用药史、华法林用药史在出血组和对照组中差异有统计学意义(P值分别为0.011、0.009、0.028、0.001、0.023)。【结论】息肉大小,合并高血压、冠心病、慢性肾病,应用阿司匹林、华法林可能是息肉切除术后迟发性出血的独立危险因素,绝大多数出血发生在术后3d内,根据患者合并危险因素进行分层,可预测患者迟发性出血的风险。

【Objective】To analyze the risk factors of delayed hemorrhage after colon polyp resection.【Methods】We retrospectively analyzed the clinical data of patients who underwent endoscopic polypectomy between January 2010 and December 2018,in which 106 patients with delayed hemorrhage were hemorrhage group,while 3 856 patients who did not bleed were the controlled group,and Logistic regression model was applied to screen the risk factors of hemorrhage after polyp resection.【Results】Of the 3 962 patients included in the study,106 had delayed postpolypectomy hemorrhage, the hemorrhage rate being 2.68%. 89.6% delayed hemorrhage occurred within 3 days after polypectomy. Logistic regression analysis showed that the difference of polyp size,complicated hypertension,combined with chronic nephropathy,aspirin drug history and warfarin drug history in hemorrhage group and control group was statistically significant(P values were 0.011,0.009,0.028,0.001,0.023,respectively).【Conclusion 】The size of polyps,comorbidity of hypertension,chronic renal disease,application of aspirin and warfarin were considered to be independent risk factors for post-polypectomy delayed hemorrhage,most of hemorrhage occurred within 3 days. According to the risk factors of patients,we may predict the risk of delayed hemorrhage.