留置金属夹预防结肠小息肉内镜黏膜切除术后迟发性出血的价值研究
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黑龙江省医院消化病院消化一科

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黑龙江省卫生健康委员会科技计划(2019-125)


Comparison of clipping or not after EMR of small colorectal polyps on preventing delayed post-polypectomy bleeding
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Heilongjiang Provincial Hospital

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Science and Technology Program of Health Commission of Heilongjiang Province(2019-125)

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    摘要:

    目的探讨直径10 mm以下无蒂结直肠息肉行内镜黏膜切除术(endoscopic mucosal resection, EMR)后,留置金属夹对于预防息肉切除术后迟发性出血(delayed post-polypectomy bleeding,DPPB)的价值。方法将2017年1月—2019年12月于黑龙江省医院消化病院因直径10 mm以下无蒂结直肠息肉拟行EMR的患者,根据计算机产生的随机序列表分为术后留置金属夹组(A组)和未留置金属夹组(B组),对比两组术后迟发性出血的相关情况。结果共纳入1 838例患者,A组912例,B组926例。两组术后迟发性出血发生率分别为1.00%(9/912)和1.10%(10/926),组间差异无统计学意义(χ2=0.039,P>0.05)。两组出血息肉个数比例为 0.44%(9/2 029)和0.49%(10/2 025),组间差异无统计学意义(χ2=0.055,P>0.05)。6~9 mm息肉(OR=11.032,95%CI:2.545~47.821,P<0.05)是无蒂结直肠息肉EMR术后迟发性出血的独立危险因素。结论10 mm以下无蒂结直肠息肉EMR治疗后,留置金属夹并未显著降低术后迟发性出血的风险。

    Abstract:

    ObjectiveTo explore the prophylactic effect of clipping after endoscopic mucosal resection(EMR) of sessile colorectal polyps of diameter below 10 mm on delayed post-polypectomy bleeding (DPPB). MethodsPatients with sessile colorectal polyps of below 10 mm undergoing EMR from January 2017 to December 2019 in Digestive Disease Hospital,Heilongjiang Provincial Hospital were randomly divided into the clipping group (group A) and the non-clipping group (group B) by random number table, and DPPB rates of both groups were compared. ResultsA total of 1 838 patients were included, 912 patients in group A and 926 patients in group B. The incidences of DPPB were 1.00% (9/912) and 1.10% (10/926) respectively, with no significant difference (χ2=0.039, P>0.05).The proportion of bleeding polyps were 0.44%(9/2 029)and 0.49%(10/2 025) respectively, with no significant difference (χ2=0.055, P>0.05). Polyp of 6-9 mm (OR=11.032, 95%CI:2.545-47.821, P<0.05) was the independent risk factor for delayed bleeding in small sessile colorectal polyps after EMR. ConclusionProphylactic clipping for sessile colorectal polyps below 10 mm after EMR may not significantly reduce the risk of DPPB.

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郭雨栋,唐秀芬.留置金属夹预防结肠小息肉内镜黏膜切除术后迟发性出血的价值研究[J].中华消化内镜杂志,2021,38(11):907-911.

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  • 收稿日期:2021-05-30
  • 最后修改日期:2021-09-23
  • 录用日期:2021-07-12
  • 在线发布日期: 2021-11-29
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