内镜下结直肠息肉切除术后迟发性出血危险因素的Meta分析

Risk factors for delayed colonic post-polypectomy bleeding:a Meta-analysis

目的分析结直肠息肉切除术后迟发性出血(DPPB)的主要危险因素。方法通过计算机检索CNKI、万方数据库、维普数据库、PubMed、Embase和Cochrane Library有关结直肠DPPB的文献,根据Cochrane系统评价手册对筛选的文献进行质量评价,选用RevMan 5.3.5软件对筛选的文献进行Meta分析。结果结直肠DPPB发生率男性高于女性(O^R=1.39,95%CI:1.12~1.72,P=0.002);高血压和糖尿病患者发生结直肠DPPB的风险增高(O^R=1.79,95%CI:1.07~3.00,P=0.030;O^R=0.53,95%CI:0.38~0.75,P=0.000);直径大于1 cm的息肉较小于1 cm的息肉更易发生结直肠DPPB(O^R=0.35,95%CI:0.21~0.59,P=0.000);有蒂息肉发生结直肠DPPB比无蒂息肉风险更高(O^R=2.37,95%CI:1.12~5.00,P=0.020);与炎性或增生性息肉相比,腺瘤性息肉患者DPPB明显升高(O^R=3.02,95%CI:1.81~5.03,P=0.000)。结论男性、高血压、糖尿病、息肉直径、息肉形态和病理类型均为影响结直肠DPPB的主要危险因素。

Objective To analyze the risk factors of delayed postpolypectomy bleeding(DPPB).Methods CNKI,Wanfang database,VIP database,PubMed,Embase and Cochrane Library were searched for studies that investigated the risk factors for DPPB.The selected literature was evaluated according to the Cochrane Systematic Review Manual.The selected articles were analyzed by RevMan 5.3.5.Results Colorectal DPPB was higher in males than that in females(O^R=1.39,95%CI:1.12~1.72,P=0.002);Patients with hypertension and diabetes were incresed risk of colorectal DPPB(O^R=1.79,95%CI:1.07~3.00,P=0.030;O^R=0.53,95%CI:0.38~0.75,P=0.000);The polyps'diameter larger than 1 cm are more likely to have colorectal DPPB(O^R=0.35,95%CI:0.21~0.59,P=0.000);The risk of colorectal DPPB in pedicled polyps was higher than in sessile polyps(O^R=2.37,95%CI:1.12~5.00,P=0.020);Patients with adenomatous polyps were more likely to have colorectal DPPB(O^R=3.02,95%CI:1.81~5.03,P=0.000).Conclusion Meta-analysis showed that male,hypertension diabetes,polyps'diameter,polyps'morphology and pathological type were risk factors for colorectal DPPB.