结肠息肉内镜下黏膜切除术后迟发性出血的危险因素分析

目的探讨行结肠息肉内镜下黏膜切除术(EMR)后发生迟发性出血的相关危险因素。方法回顾性分析2016年1月-2018年12月在该院行结肠息肉EMR治疗的328例患者的临床资料。以是否发生迟发性出血分为两组(出血组和未出血组),对比两组患者临床指标的差异,采用Logistic回归模型分析EMR术后迟发性出血的独立危险因素。结果328例患者中发生术后迟发性出血22例(6.71%)。两组患者的年龄、高血压、肝硬化、抗凝药服用史、体质指数(BMI)、息肉大小、息肉形态和息肉数量比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析显示,高血压、抗凝药服用史、息肉大小、息肉形态与迟发性出血发生存在密切关系(P<0.05)。结论结肠息肉患者合并高血压、长期服用抗凝药、息肉大小和息肉形态是发生EMR术后迟发性出血的独立危险因素。

Risk factors for delayed bleeding after endoscopic mucosal resection of colonic polyps

Objective To investigate the risk factors for delayed bleeding after endoscopic mucosal resection(EMR).Methods The clinical data of patients with colonic polyp EMR from 2016 to 2018 were retrospectively analyzed.The patients with delayed bleeding were divided into two groups(bleeding group and non-bleeding group).The differences of clinical indexes between the two groups were compared.Logistic regression model was used to analyze the independent risk factors of delayed bleeding after EMR.Results The clinical data of 328 patients with colonic polyps treated by EMR were collected.22 patients(6.71%)suffered from delayed bleeding.There were significant differences between the two groups in age,hypertension,cirrhosis,anticoagulant administration history,BMI,polyp size,polyp shape,polyp number(P<0.05);multivariate logistic regression analysis showed that hypertension,anticoagulant administration history,polyp size,polyp shape and delayed bleeding were closely related(P<0.05).Conclusion Patients with colonic polyps with hypertension,long-term use of anticoagulants,polyp size,and polyp morphology are independent risk factors for delayed bleeding after EMR.