老年结肠息肉患者电子结肠镜下高频电切术后迟发性出血的危险因素分析

Risk factors analysis of delayed hemorrhage after high-frequency electrotomy under electronic colonoscopy in elderly patients with colonic polyps

目的分析老年结肠息肉患者电子结肠镜下高频电切术后迟发性出血的危险因素。方法回顾性分析2017年1月至2018年12月海口市人民医院收治的505例老年结肠息肉患者的临床资料。根据患者电子结肠镜下高频电切术后迟发性出血的发生情况,将入选患者分别纳入发生组和未发生组,计算患者术后迟发性出血的发生率,并比较两组患者的临床资料,应用Logistic多因素回归分析影响老年结肠息肉患者电子结肠镜下高频电切术后迟发性出血的危险因素。结果505例患者中,37例患者发生术后迟发性出血,发生率为7.33%;患者迟发性出血发生时间为术后1~7(3.71±0.80)d。Logistic多因素回归分析显示,息肉数量≥3枚、息肉直径≥1 cm、有蒂息肉、术中出血量≥50 ml及合并高脂血症均是影响老年结肠息肉患者电子结肠镜下高频电切术后迟发性出血的独立危险因素(均P<0.05)。结论老年结直肠息肉患者电子结肠镜下高频电切术后迟发性出血的危险因素包括息肉特征、术中出血量、合并症等,充分评估患者迟发性出血风险并采取相应预防措施,有望降低其迟发性出血发生风险。

Objective To analysis of risk factors for delayed hemorrhage after high-frequency electrotomy under electronic colonoscopy in elderly patients with colon polyps.Method The clinical data of 505 elderly patients with colon polyps admitted to Haikou People's Hospital from January 2017 to December 2018 were retrospectively analyzed.According to the occurrence of delayed hemorrhage after high-frequency electrotomy under electronic colonoscopy,the patients were divided into the occurrence group and the non-occurrence group.The incidence of delayed hemorrhage after operation was calculated and the clinical data of the two groups were compared.Logistic multivariate regression analysis was used to investigate the risk factors of postoperative delayed hemorrhage.Result Of the 505 patients,37 patients had delayed hemorrhage after operation,the incidence was 7.33%.The occurrence time of delayed hemorrhage was 1~7 days after operation,with an average of(3.71±0.80)days.Logistic multivariate regression analysis showed that the number of polyps≥3,the diameter of polyps≥1 cm,pedicled polyps,intraoperative bleeding≥50 ml and hyperlipidemia were independent risk factors for delayed hemorrhage in elderly patients with colonic polyps after high-frequency electrotomy under electronic colonoscopy(all P<0.05).Conclusion The risk factors of delayed hemorrhage in elderly patients with colonic polyps after high-frequency electrotomy under electronic colonoscopy include polyp characteristics,intraoperative bleeding volume and complications.It is expected to reduce the risk of delayed hemorrhage by fully evaluating the risk of delayed hemorrhage and taking appropriate preventive measures.