内镜下冷圈套器切除直径<1cm的结直肠息肉疗效及迟发出血风险分析

doi:10.3969/j.issn.1006-6233.2022.05.033

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Abstract Objective: To explore the efficacy of endoscopic cold snare resection of colorectal polyps with a diameter<1 cm and the risk factors for delayed bleeding. Methods: The data of 410 patients with colorectal polyps with a diameter<1cm who underwent endoscopic resection from September 2018 to February 2020 were retrospectively analyzed, and according to the different resection methods, they were divided into cold snare resection group (n=214 cases) and hot snare resection group (n=196 cases). The polyp resection time, complete polyp resection rate, polyp recovery rate were compared, complication occurrence of the two groups of patients and the occurrence of delayed bleeding were counted, and the clinical characteristics of bleeding patients and non-bleeding patients were compared. Logistic regression analysis was used to determine the factors affecting delayed bleeding in patients with colorectal polyps with a diameter<1 cm under endoscopic resection. Results: There were no statistically significant difference in the basic data of the two groups of patients (P>0.05). The time of polyp removal in the cold snare resection group was shorter than that in the hot snare resection group (P<0.05), and the incidence of delayed bleeding in the cold snare resection group was lower than that in the hot snare resection group (P<0.05) , there were no statistically significant difference in the resection rate of intact polyps, the recovery rate of polyps, the incidence of abdominal discomfort, and the incidence of perforation between the two groups (P>0.05). Compared with patients without bleeding, there were no statistically significant difference in gender, diabetes, coronary heart disease, hypertension, cerebrovascular disease, polyp number, use of titanium clamps, polyp pathological type, anticoagulant medication history, age, and polyp diameter (P>0.05), the polyp position, intraoperative bleeding, polyp morphology, and composition ratio of the resection method in bleeding patients were compared with those in non-bleeding patients, and the differences were statistically significant (P<0.05). Logistic multivariate regression analysis showed that polyp location, polyp morphology, and resection method are independent risk factors for delayed bleeding in patients with colorectal polyps with a diameter<1cm under endoscopic resection (P<0.05). Conclusion: Endoscopic cold snare resection for patients with colorectal polyps with diameter<1cm can shorten the time of polyp resection and reduce the incidence of delayed bleeding. In addition, the location of polyps, polyp morphology, and resection methods are independent risk factors that affect delayed bleeding in patients with colorectal polyps with a diameter diameter<1 cm under endoscopic resection.

Key words： Colorectal polyps Cold snare resection under endoscopy Delayed bleeding Risk factors

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.05.033 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I5/857

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