内镜下大肠息肉切除术后迟发性出血危险因素分析

Analysis on the risk factors of delayed bleeding after endoscopic resection of colorectal polyp

目的 分析内镜下大肠息肉切除术后迟发性出血(DPPB)的危险因素,为临床预防术后迟发性出血提供依据。方法 回顾性分析2019年1月至2022年12月在内蒙古林业总医院内镜室行内镜下大肠息肉切除术1479例患者,根据是否术后发生迟发性出血分为DPPB组和非DPPB组,对两组患者基本情况和息肉的情况进行单因素和多因素分析,评估DPPB的危险因素。结果 在1479例患者中发生DPPB患者31例,发生率为2.10%。合并高血压、合并糖尿病、术中出血、右半结肠息肉、直肠息肉、息肉直径≥1.0 cm、息肉形态(有蒂)是DPPB的独立危险因素(P <0.05)。结论 对于右半结肠息肉、直肠息肉、≥1.0 cm息肉、息肉形态(有蒂)、合并高血压、糖尿病的患者,临床医生应予重视以避免DPPB的发生。

Objective To analyze the risk factors of delayed post polypectomy bleeding(DPPB)of large intestine,so as to provide evidence for clinical prevention of delayed bleeding after operation.Methods A retrospective analysis was conducted on 1479 patients who underwent endoscopic colorectal polypectomy in the Department of Endoscopy of The General Hospital of Forestry of Inner Mongolia from January 2019 to December 2022.According to whether there was DPPB,they were divided into the DPPB group and the non-DPPB group.Univariate and multivariate analysis were conducted on the basic condition of patients and polyps in the two groups to evaluate the risk factors of DPPB.Results In 1479 patients,31 patients developed DPPB,and the incidence was 2.10%.The independent risk factors of DPPB were complicated hypertension,complicated diabetes,intraoperative bleeding,right colon polyps,rectal polyps,polyp diameter≥1.0 cm and polyp morphology(pedicled)(P<0.05).Conclusion Clinicians should pay attention to patients with right colon polyps,rectal polyps,polyps diameter≥1.0 cm,polyp morphology(pedicled),hypertension and diabetes to avoid the occurrence of DPPB.