【摘要】 目的探讨结直肠息肉内镜下黏膜切除术后迟发性出血的危险因素。方法选取本院2014年1月至2018年1月收治的结直肠息肉患者573例为研究对象,均行内镜下黏膜切除术治疗,观察术后迟发性出血发生情况,按照是否发生迟发性出血分为出血组(26例)和未出血组(547例)。采用单因素和多因素Logistic回归分析术后迟发性出血的危险因素。结果行内镜下黏膜切除术的573例结直肠息肉患者发生术后迟发性出血26例,发生率为4.54%。两组患者性别、术前服用阿司匹林/华法林/氯吡格雷例数、血红蛋白水平、吸烟例数、息肉数量比较均无显著差异(P_均>0.05);出血组中年龄≥50岁、合并糖尿病、合并高血压、术中出血、追加镇静药物、息肉直径≥0.9 cm的患者均显著多于未出血组(P_均<0.05)。多因素Logistic回归分析显示:年龄≥50岁、合并高血压、术中出血、追加镇静药物为影响结直肠息肉内镜下黏膜切除术后迟发性出血的独立危险因素。结论结直肠息肉内镜下黏膜切除术后迟发性出血受多种因素影响,为预防其发生,应做好相应的预防措施。更多还原

【Abstract】 Objective To investigate the risk factors of delayed hemorrhage after endoscopic mucosal resection for colorectal polyp. Method 573 patients with colorectal polyp were selected from January 2014 to January 2018 in our hospital. Endoscopic mucosal resection was performed to observe the incidence of delayed hemorrhage after surgery, according to whether there was delayed bleeding, they were divided into hemorrhage group(n = 26) and non-hemorrhage group(n = 547). Single factor and multiple factor Logistic regression were used to analyze the risk factors of delayed hemorrhage after surgery. Result 573 patients with colorectal polyp underwent endoscopic mucosal resection, and 26 patients had delayed hemorrhage after surgery, the incidence rate was 4.54%. The single factor analysis showed that there was no significant difference in sex, the number of patients took Aspirin or Warfarin or Clopidogrel before operation, hemoglobin, smoking and the numbers of polyps between the two groups(Pall> 0.05). Patients with ≥ 50 years old, combined with diabetes, combined hypertension, intraoperative bleeding, adding sedative drugs, and polyp diameter ≥ 0.9 cm in hemorrhage group were significantly more than those in non-hemorrhage group(Pall< 0.05). Multivariate Logistic regression analysis showed that: ≥ 50 years old, combined with diabetes, combined hypertension, intraoperative bleeding, adding sedative drugs were independent risk factors of delayed hemorrhage after endoscopic mucosal resection for colorectal polyp. Conclusion Delayed hemorrhage after endoscopic mucosal resection of colorectal polyps is influenced by many factors, preventive measures should be taken to prevent it.更多还原