摘要
目的探讨直径<10 mm结直肠息肉内镜下圈套切除效果,分析迟发性出血的发生情况及危险因素。方法按照随机数表法将2020年1月至2022年3月延安市中医医院收治的150例直径<10 mm结直肠息肉患者分为冷切除组(内镜下冷圈套切除术)与热切除组(内镜下热圈套切除术),每组75例。比较两组患者的手术相关指标(息肉切除时间、完整息肉切除率、息肉回收率)、并发症及迟发性出血情况,采用多因素Logistic回归分析迟发性出血的危险因素。结果冷切除组与热切除组患者的息肉切除时间、完整息肉切除率、息肉回收率、并发症发生率比较差异均无统计学意义(P<0.05);冷切除组患者的迟发性出血发生率为5.33%,明显低于热切除组的21.33%,差异有统计学意义(P<0.05);出血患者与未出血患者的息肉位置、息肉形态、术中出血情况、切除方式比较差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示:息肉位于直肠、息肉有蒂、热切除是直径<10 mm结直肠息肉内镜下圈套切除术后迟发性出血的独立危险因素(P<0.05)。结论内镜下冷圈套切除术能明显降低直径<10 mm结直肠息肉术后迟发性出血发生率,息肉位于直肠、息肉有蒂、热切除是其危险因素。
Objective To discuss the effect of endoscopic snare resection of colorectal polyps with diameter<10 mm,and to analyze the occurrence and risk factors of delayed bleeding.Methods According to the random number table method,a total of 150 patients with colorectal polyps with diameter<10 mm in Yan'an Hospital of Traditional Chinese Medicine from January 2020 to March 2022 were divided into cold resection group(endoscopic cold trap resection)and hot resection group(endoscopic hot trap resection),with 75 patients in each group.The operative indicators(polyps removal time,polyps removal rate,polyps recovery rate),complications,and delayed bleeding were compared between the two groups,and the risk factors of delayed bleeding were analyzed by multivariate Logistic regression analysis.Results There were no significant differences in polyps removal time,polyps removal rate,polyps recovery rate,and complications between cold resection group and hot resection group(P>0.05).The incidence of delayed bleeding in cold resection group was 5.33%,which was significantly lower than 21.33%in hot resection group(P<0.05).There were significant differences in polyp location,polyp morphology,intraoperative bleeding,and resection methods between patients with and without bleeding(P<0.05).Multivariate Logistic regression analysis showed that polyps located in rectum,pedicled polyps,and hot resection were independent risk factors for delayed bleeding after endoscopic endoscopic resection of colorectal polyps<10 mm in diameter(P<0.05).Conclusion The endoscopic cold snare resection could significantly reduce the incidence of postoperative delayed bleeding of colorectal polyps with diameter<10 mm.Polyps located in the rectum,pedicled polyps,and hot resection were the risk factors.
作者
蒋宝玲
刘娟
申妮
JIANG Bao-ling;LIU Juan;SHEN Ni(Gastroscopy Center,Department of Gastroenterology,Yan'an Hospital of Traditional Chinese Medicine,Yan'an 716000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第8期1110-1113,共4页
Hainan Medical Journal
