微创医学

目的探讨结直肠息肉患者行内镜下黏膜切除术（EMR）时术中出血的相关因素。方法纳入471例接受EMR的结直肠息肉患者作为研究对象，根据术中是否出血将其分为观察组和对照组。收集患者的基本信息、病理因素及手术相关因素等临床资料，采用多因素Logistic回归模型分析术中出血的影响因素。结果共38例患者发生术中出血，出血发生率为8.07%。多因素Logistic回归分析结果显示，息肉发生部位、息肉数量、钛夹数量为EMR术中出血的独立影响因素（均P<0.05）。术中出血与术后出血、术后禁食时间相关（P<0.05）。结论息肉发生部位、息肉数量、钛夹数量是肠息肉EMR术中出血的独立影响因素，临床上应针对影响因素进行预防，以降低术后相关并发症的发生率。

Objective To investigate the related factors intraoperative bleeding in patients with colorectal polyps undergoing endoscopic mucosal resection (EMR). Methods A total of 471 patients with colorectal polyps who received EMR were enrolled as research objects and divided into an observation group and a control group based on whether there was intraoperative bleeding. Clinical data such as basic information, pathological factors and surgical related factors of patients were collected, and the influencing factors of intraoperative bleeding were analyzed by multivariate Logistic regression model. Results A total of 38 patients had intraoperative bleeding, with an incidence of 8.07%. The results of multivariate logistic regression analysis showed that the location of polyps, number of polyps, and number of titanium clips were independent influencing factors for intraoperative bleeding in EMR (all P<0.05). Intraoperative bleeding was correlated with postoperative bleeding and postoperative fasting time (P<0.05). Conclusion The location of polyps, number of polyps, and number of titanium clips are independent influencing factors of bleeding during EMR of intestinal polyps. Clinical prevention should be carried out according to the influencing factors to reduce the incidence of postoperative related complications.

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