【摘要】 目的：分析早期结直肠病变患者行内镜下黏膜剥离术（ESD）后发生电凝综合征的高危因素。方法：回顾性分析2021年1月—2023年1月甘肃省人民医院收治的126例行ESD治疗的早期结直肠病变患者的病历资料，统计其术后电凝综合征的发生率，根据是否发生电凝综合征将患者分为发生组（n=21）和未发生组（n=105），另收集两组的年龄、性别等资料，采用单因素和多因素logistic回归分析ESD后发生电凝综合征的高危因素。结果：行ESD治疗的早期结直肠病变患者中术后有21例发生电凝综合征，发生率为16.67%(21/126)。单因素分析显示，两组性别、体重指数（BMI）、文化程度、吸烟史、饮酒史、高血压史、糖尿病史比较，差异无统计学意义（P>0.05）；发生组年龄>60岁、病变直径≥5 cm、结肠病变、恶性肿瘤、广基息肉、分块切除患者占比高于未发生组，差异有统计学意义（P<0.05）。logistic回归分析显示，年龄>60岁（β=1.928,OR=6.875,95%CI:2.428,19.468）、病变直径≥5 cm(β=2.033,OR=7.639,95%CI:2.573,22.679)、结肠病变（β=1.973,OR=7.192,95%CI:2.257,22.918）、恶性肿瘤（β=1.525,OR=4.595,95%CI:1.644,12.843）、广基息肉（β=1.705,OR=5.500,95%CI:2.013,15.027）、分块切除（β=2.491,OR=12.073,95%CI:3.984,36.586）为早期结直肠病变患者ESD后发生电凝综合征的高危因素（P<0.05）。结论：ESD后发生电凝综合征的风险较高，而年龄>60岁、病变直径≥5 cm、结肠病变、恶性肿瘤、广基息肉、分块切除等是早期结直肠病变患者ESD后发生电凝综合征的高危因素，临床需予以高度重视。更多还原

【Abstract】 Objective: To analyze the high-risk factors for the occurrence of electrocoagulation syndrome after endoscopic submucosal dissection(ESD) in patients with early colorectal lesions. Method: Retrospective analysis of case data of 126 patients with early colorectal lesions who underwent ESD treatment at Gansu Provincial Hospital from January 2021 to January 2023, the incidence of postoperative electrocoagulation syndrome was analyzed. Patients were divided into occurrence group(n=21) and non occurrence group(n=105) based on the occurrence of electrocoagulation syndrome. Age, gender, and other data from two groups were also collected, and the risk factors of electrocoagulation syndrome after ESD were analyzed by univariate and multivariate logistic regression. Result: A total of 21 patients with early colorectal lesions undergoing ESD treatment developed electrocoagulation syndrome, with an incidence rate of 16.67%(21/126). Univariate analysis showed that there were no significant differences between the two groups in gender, body mass index(BMI), education level, smoking history, drinking history, hypertension history and diabetes history(P>0.05). The proportion of patients with age >60 years old, lesion diameter ≥5 cm, colon lesions, malignant tumors, wide base polyps, and block resection in the occurrence group were higher than those in the non occurrence group, and the differences were statistically significant(P<0.05). logistic regression analysis shows that age >60 years old(β=1.928, OR=6.875, 95%CI: 2.428, 19.468), lesion diameter ≥5 cm(β=2.033, OR=7.639,95%CI: 2.573, 22.679), colon lesions(β=1.973, OR=7.192, 95%CI: 2.257, 22.918), malignant tumors(β=1.525, OR=4.595, 95%CI:1.644, 12.843), wide base polyps(β=1.705, OR=5.500, 95%CI: 2.013, 15.027), block resection(β=2.491, OR=12.073, 95%CI: 3.984,36.586) were high-risk factor for the occurrence of electrocoagulation syndrome after ESD in patients with early colorectal lesions(P<0.05).Conclusion: The risk of developing electrocoagulation syndrome after ESD is high, and age >60 years old, lesion diameter ≥5 cm, colon lesions, malignant tumors, wide base polyps, block resection are high-risk factors for the occurrence of electrocoagulation syndrome after ESD in patients with early colorectal lesions, which should be highly valued in clinical practice.更多还原