Risk factors for delayed bleeding after intestinal polypectomy in children
10.7499/j.issn.1008-8830.2306060
- VernacularTitle:儿童肠息肉切除术后迟发性出血的危险因素分析
- Author:
Yue-Sheng WANG
1
;
Jing ZHANG
;
Fu-Min XUE
;
Jing YU
;
Xiao-Qin LI
Author Information
1. 郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院消化内科,河南郑州 450018
- Keywords:
Intestinal polyp;
Delayed bleeding;
Risk factor;
Child
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(1):48-53
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics and risk factors of delayed bleeding after intestinal polypectomy in children,and to provide a theoretical basis for clinical surgical intervention of intestinal polyps.Methods A retrospective analysis was conducted on the clinical data of 2 456 children with intestinal polyps who underwent endoscopic high-frequency electrocoagulation loop resection in the Endoscopy Center of Children's Hospital Affiliated to Zhengzhou University from January 2014 to December 2021.According to the presence or absence of delayed bleeding after surgery,they were divided into bleeding group with 79 children and non-bleeding group with 2 377 children.A multivariate logistic regression analysis was used to investigate the risk factors for delayed bleeding.The receiver operating characteristic(ROC)curve was used to investigate the value of various indicators in predicting delayed bleeding.Results Of all 2 456 children,79(3.22%)experienced delayed bleeding,among whom 5 children with severe delayed bleeding underwent emergency colonoscopy for hemostasis and 74 received conservative treatment,and successful hemostasis was achieved for all children.There were significant differences between the bleeding and non-bleeding groups in age,body mass index,constipation rate,location of lesion,time of endoscopic procedure,resection method(P<0.05).Children with a diameter of polyps of 6-10 mm and>20 mm were more likely to develop delayed bleeding after resection(P<0.05).The multivariate logistic regression analysis showed that endoscopic operation time,polyp diameter,and resection method were significantly associated with delayed bleeding(P<0.05).The ROC curve analysis showed that the endoscopic operation time,polyp diameter,and resection method had a good value in predicting delayed bleeding after intestinal polypectomy,with an area under the ROC curve of 0.706,0.688,and 0.627,respectively.Conclusions Endoscopic high-frequency electrocoagulation loop resection has a lower incidence of delayed bleeding in children with intestinal polyps,and the endoscopic operation time,polyp diameter,and resection method are closely associated with the occurrence of postoperative delayed bleeding.
