内镜黏膜切除术治疗结直肠息肉疗效观察及术后迟发性出血的相关危险因素分析

Clinical Efficacy of Endoscopic Mucosal Resection in Treatment of Patients with Colorectal Polyps and Analysis of Related Risk Factors for Delayed Hemorrhage after Surgery

目的分析内镜黏膜切除术(EMR)治疗结直肠息肉的临床效果及术后迟发性出血的相关危险因素。方法回顾性分析2018年6月—2021年5月收治的结直肠息肉102例的临床资料,根据手术方法分为对照组50例和研究组52例。研究组给予EMR治疗,对照组给予内镜下电凝切除术治疗。对比2组临床疗效、手术指标;根据患者是否发生术后迟发性出血分为出血组及未出血组,分析结直肠息肉患者术后迟发性出血的相关危险因素。结果研究组总有效率高于对照组(P<0.05)。研究组手术时间、术后胃肠功能恢复时间及住院时间短于对照组,术中出血量少于对照组(P<0.01)。术后发生迟发性出血25例,未发生出血77例。切除方式、息肉直径、息肉位置、病理类型、息肉数目、息肉形态是结直肠息肉患者术后迟发性出血的独立危险因素(P<0.01)。结论EMR治疗结直肠息肉的临床效果确切,能够促进患者恢复,但临床需重视上述危险因素,并早期采取预防治疗措施。

Objective To analyze clinical efficacy of endoscopic mucosal resection(EMR)in treatment of patients with colorectal polyps(CRP)and related risk factors for delayed hemorrhage after surgery.Methods Clinical data of 102 patients with CRP admitted between June 2018 and May 2021 were retrospectively analyzed,and the patients were divided into control group(n=50)and research group(n=52)according to surgical methods.Research group was treated with EMR,while control group was treated with endoscopic electrocoagulation.Clinical efficacy and surgical indexes were compared between two groups.The patients were divided into bleeding group and non-bleeding group according to presence of delayed hemorrhage after surgery.Related risk factors of delayed hemorrhage after the surgery in patients with CRP were analyzed.Results The total effective rate in research group was significantly higher than that in control group(P<0.05).Operative duration,postoperative recovery time of gastrointestinal function,length of hospital stay and volume of intraoperative bleeding in research group were significantly shorter or less than those in control group(P<0.01).There were 25 patients with delayed hemorrhage after surgery and 77 patients without bleeding.Resection method,polyp diameter,polyp location,pathological type,polyp number and polyp morphology were independent risk factors for occurrence of delayed hemorrhage after surgery in patients with CRP(P<0.01).Conclusion EMR is effective in treatment of CRP patients,and it may promote the recovery of patients.However,the above risk factors should be paid attention,and preventive and therapeutic measures should be given in the early stage.