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Clinic Study on Post-polypectomy Hemorrhage

Author: ZhangYaZuo
Tutor: PanWenSheng
School: Zhejiang University
Course: Internal Medicine
Keywords: Colorectal polyps Endoscopic polypectomy Hemorrhage
CLC: R735.3
Type: Master's thesis
Year: 2010
Downloads: 32
Quote: 0
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Abstract


Objective:To explore the correlation factors and methods of post-polypectomy hemorrhage.Method:A total of 313 patients with 373 lesions were included in this study. The patients were divided into two groups according to hemorrhage or not.Their clinical data were retrospectively univariately and multivariately analyzed by SPSS 16 software.Results:non-hemorrhage group:302 cases with colorectal polyps were curatively resected and 356 polyps in all.23 cases were treated by hot biopsy forceps,299 cases were treated by snare high frequency electroexcision,32 cases were treated by endoscopic mucosal resection and 2 cases by endoscopic submucosal dissection.hemorrhage group: 11 cases were found post-polypectomy hemorrhage. the hemorrhage rate was 3.5%. There were 4 cases treated by hot biopsy forceps,10 cases treated by snare high frequency electroexcision,3 cases treated by endoscopic mucosal resection. Only one patient which polyps dimeter was 4cm was transferred to surgery with acute bleeding, early delayed bleeding occurred in 1 case with thick pedical; Late delayed bleeding occurred in 9 cases:3 cases of eating too much greasy food; 3 cases of complicated with hypertension; 1 case of excessive exercise; 1 case of long-term adrenal cortex hormones intake; 1 case of being injured of vessel during endoscopic mucosal resection procedure, all cases were cured by endoscopic or drugs. Regression analysis showed that the independent risk factor of post-polypectomy hemorrhage is hypertension(p<0.01).Conclutions:Hypertension is an independent risk factor of post-polypectomy hemorrhage. The dimeter of polyps, thick pedicle, the artery in pedicle, and adrenocortical hormones intake are correlation factors of hemorrhage. Greasy food and excess exercises after polypectomy are the possible inducements of hemorrhage.

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