结直肠腺瘤切除术后复发的危险因素

Risk factors for recurrence after colorectal adenoma resection

目的:探讨结直肠腺瘤性息肉切除术后复发的危险因素,为其防治提供参考。方法:回顾性收集首次行内镜下息肉切除术,且至少有一次肠镜随访结果的患者,根据是否复发分为复发组及对照组,分析影响结直肠腺瘤复发的相关因素。结果:两组患者性别、年龄、体重指数(BMI)比较,差异无统计学意义(P>0.05);在吸烟史、非酒精性脂肪肝病史、息肉数目及部位、蔬菜、红肉、高钙食物或钙剂摄入的差异具有统计学意义(P<0.05)。多因素Logistic回归分析发现,非酒精性脂肪肝、吸烟、息肉数目≥3个、进食较多红肉是结直肠腺瘤复发的独立危险因素,高钙食物或钙剂以及蔬菜的大量摄入是腺瘤复发的保护性因素。结论:非酒精性脂肪肝、吸烟、息肉数目≥3个、进食较多红肉是结直肠腺瘤复发的独立危险因素,摄入高钙食物或钙剂以及蔬菜的大量摄入是腺瘤复发的保护性因素。结直肠腺瘤切除术后应结合患者的实际状况制定个性化随访方案,有利于降低复发的风险。

Objective To investigate the risk factors for recurrence of colorectal adenomatous polyps(adenoma) after resection, and to provide reference for its prevention and treatment. Method Retrospective collection of patients who underwent endoscopic polypectomy for the first time, and who had at least one colonoscopy follow-up result According to whether it recurred, they was divided into recurrence group and control group. The clinical data of the two groups of patients were collected to analyze the relevant factors affecting the recurrence of colorectal adenoma.Results There was no difference in the distribution of gender and age between the recurrence group and the control group. The difference in BMI was not statistically significant(P>0.05). The recurrence of adenoma and the history of smoking, history of non-alcoholic fatty liver disease, and the number of polyps It was related to parts, vegetables, red meat, high-calcium foods or calcium intake, and the difference was statistically significant(P<0.05). Multivariate logistic regression analysis found that non-alcoholic fatty liver, smoking, the number of polyps ≥3, and eating more red meat are independent risk factors for the recurrence of colorectal adenomas. Intake of high-calcium foods or calcium agents and large amounts of vegetables Incoming is a protective factor for adenoma recurrence.Conclusion NAFLD, smoking, the number of polyps ≥3, and a large amount of red meat intake are independent risk factors for the recurrence of colorectal adenomas. High calcium of foods or calcium supplements and high intake of vegetables are the protective effects of adenoma recurrence factor.