大理大学学报 ›› 2026, Vol. 11 ›› Issue (2): 42-47.DOI: 10. 3969 / j. issn. 2096-2266. 2026. 02. 007

• 临床医学 • 上一篇    下一篇

大肠息肉内镜下切除术后迟发性出血的危险因素分析

施杜渲,杨晓英,刘 洋,李博文,赵春萍*   

  1. (大理市第一人民医院消化科,云南大理 671000)
  • 收稿日期:2025-05-13 修回日期:2025-10-27 出版日期:2026-02-15 发布日期:2026-03-18
  • 通讯作者: 赵春萍,主治医师,E-mail:1094071956@qq.com。
  • 作者简介:施杜渲,主治医师,主要从事消化内科临床诊疗研究。

Analysis of Risk Factors for Delayed Bleeding after Endoscopic Resection of Colorectal Polyps

Shi Duxuan, Yang Xiaoying, Liu Yang, Li Bowen, Zhao Chunping*   

  1. (Department of Gastroenterology, The First People′s Hospital of Dali City, Dali, Yunnan 671000, China)
  • Received:2025-05-13 Revised:2025-10-27 Online:2026-02-15 Published:2026-03-18

摘要: 目的:分析大肠息肉内镜下切除术后迟发性出血的危险因素,为临床风险评估及围手术期管理提供参考依据。方法:
回顾性分析2021年1月至2022年12月在大理市第一人民医院内镜中心接受大肠息肉内镜下切除术的2 688例患者的临床资
料,记录一般信息、息肉特征及手术相关资料。根据术后是否发生迟发性出血将患者分为出血组与未出血组,采用单因素分析
筛选相关因素,再进行多因素Logistic 回归分析以确定独立危险因素。结果:2 688 例患者中迟发性出血55 例,发生率为
2.05%,出血时间集中于术后1~9 d。单因素分析显示年龄、性别、体重指数(BMI)、息肉直径、息肉部位及形态与迟发性出血相
关(P<0.05)。多因素Logistic回归分析显示,男性、年龄较小、BMI≥24 kg/m2、息肉直径≥1 cm、息肉位于右半结肠及有蒂息肉为
迟发性出血的独立危险因素。结论:大肠息肉内镜下切除术后迟发性出血发生率较低,但男性、年轻患者、超重或肥胖、息肉直
径较大、位于右半结肠及有蒂息肉是大肠息肉切除术后迟发性出血的主要危险因素。识别高危患者并采取针对性预防措施可
有效降低术后出血风险,提高临床治疗安全性。

关键词: 大肠息肉, 迟发性出血, 内镜下切除术, 危险因素, Logistic回归

Abstract: Objective: To analyze the risk factors for delayed bleeding after endoscopic resection of colorectal polyps, and to provide a
reference for clinical risk assessment and perioperative management. Methods: A retrospective analysis was conducted on 2 688 pa⁃
tients who underwent endoscopic colorectal polypectomy in the Endoscopy Center of the First People′s Hospital of Dali City from Janu⁃
ary 2021 to December 2022. General clinical characteristics, polyp features, and surgical information were collected. Patients were di⁃
vided into a bleeding group and a non-bleeding group according to the occurrence of delayed bleeding. Univariate analysis was per⁃
formed to identify associated factors, followed by multivariate Logistic regression to determine independent risk factors. Results:
Among 2 688 patients, delayed bleeding occurred in 55 cases, with an incidence rate of 2.05%, mostly occurring within 1-9 days post⁃
operatively. Univariate analysis showed that age, sex, body mass index (BMI), polyp diameter, location, and morphology were associated
with delayed bleeding (P<0.05). Multivariate Logistic regression indicated that male, younger age, BMI≥24 kg/m2, polyp diameter≥1 cm,
right-sided colonic location, and pedunculated polyps were independent risk factors for delayed bleeding. Conclusion: The incidence
of delayed bleeding after endoscopic resection of colorectal polyps is relatively low. However, male patients, younger individuals, those
who are overweight or obese, and patients with larger polyps, right-sided colorectal polyps, or pedunculated polyps have an increased
risk. Identifying high-risk patients and implementing targeted preventive measures can effectively reduce the risk of postoperative
bleeding and improve treatment safety.

Key words: colorectal polyps, delayed bleeding, endoscopic resection, risk factors, Logistic regression

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