摘要
背景结肠镜下息肉高频电切除术(endoscopic mucosal resection,EMR)是治疗结直肠息肉的常见方法.手术后的禁食时间长短一直是临床关注的焦点,然而目前对于禁食时间与出血、感染、穿孔发生之间的相关性研究相对不足.目的探讨EMR术后禁食时间长短与出血、感染、穿孔发生的关系,以提供术后患者禁食策略的指导.方法在2000-2023路桥区第二人民医院收治的14857例结直肠息肉患者队列中,采用倾向评分匹配的病例对照研究设计,评估40岁及以上成年人息肉切除术后出血和穿孔的相关风险;3505例术后短时间禁食和9669例术后长时间禁食患者符合研究标准.每组共匹配2560例患者进行进一步分析.试验组术后禁食时间2 h,对照组术后禁食时间24 h,根据切口的大小、手术的效果逐渐将流质食物换成半流质食物、普通食物.术后均随访1 mo,记录两组患者的术后出血、感染和穿孔发生率.结果在短时间禁食组中出血、感染或穿孔的出现率分别为0.64%,0.07%和0.07%.在长时间禁食组中出血、感染或穿孔的出现率分别为0.40%,0.04%和0.04%.在出血、感染和穿孔发生率方面,两组之间没有显著差异.结论术后禁食时间对于结肠镜下息肉高频电切除手术后的出血、感染和穿孔发生率没有显著影响.对于选择禁食时间,可以根据患者的具体情况和实际需要来制定策略.然而,需要注意的是,这只是一项回顾性分析研究,还需要更多的临床研究来进一步验证这一观察结果,并探讨其他可能的影响因素.
BACKGROUND Endoscopic mucosal resection(EMR)is a common method for treating colorectal polyps.The duration of fasting after the operation has been the focus of clinical attention.However,there is currently a lack of research on the correlation between fasting duration and the occurrence of bleeding,infection,and perforation.AIM To explore the relationship between fasting time and bleeding,infection,and perforation after colonoscopic electro-resection of polyps to provide guidance on fasting strategies for postoperative patients.METHODS In a cohort of 14857 colorectal polyp patients admitted to the Second People’s Hospital of Luqiao District from 2000 to 2023,a case-control study design with matching propensity scores was used to evaluate the risk of bleeding and perforation after polypectomy in adults aged 40 years and older;3505 patients with short-term postoperative fasting and 9669 patients with prolonged postoperative fasting met the study criteria.A total of 2560 patients in each group were matched for further analysis.The postoperative fasting time of the experimental group was 2 h,and the postoperative fasting time of the control group was 24 h.The liquid food was gradually replaced with semi-liquid food and ordinary food according to the size of the incision and the effect of the operation.The postoperative follow-up duration was 1 mo,and the incidence of postoperative bleeding,infection,and perforation in both groups was recorded.RESULTS In the short fasting group,the rates of bleeding,infection,and perforation were 0.64%,0.07%,and 0.07%,respectively.In the long fasting group,the rates of bleeding,infection,and perforation were 0.40%,0.04%,and 0.04%,respectively.There was no significant difference between the two groups in terms of the rates of bleeding,infection,and perforation.CONCLUSION Based on these results,it can be preliminarily concluded that the duration of postoperative fasting may not have a significant effect on the incidence of bleeding,infection,and perforation after colonoscopic high-fre
作者
徐军斌
Jun-Bin Xu(Department of Gastroenterology,The Second People’s Hospital of Luqiao District,Taizhou 318058,Zhejiang Province,China)
出处
《世界华人消化杂志》
CAS
2023年第23期973-980,共8页
World Chinese Journal of Digestology
关键词
高频电切除术
结肠息肉
出血
感染
穿孔
High-frequency electroresection
Colon polyps
Bleeding
Infection
Perforation
