结直肠息肉切除术后患者复查情况及影响因素研究

Status and influencing factors of surveillance in colorectal post‑polypectomy patients

摘要:

目的 探究结直肠息肉切除术后患者复查情况及其影响因素。方法 回顾性收集武汉大学人民医院2019年4月1日至6月30日行结肠镜下息肉切除术的患者，采用电子病历查询联合电话回访收集患者的复查信息。整理分析结直肠息肉切除术后患者复查情况及影响复查的因素，使用Logistic回归进行多因素分析确定影响复查的独立危险因素。结果 共纳入268例行结直肠息肉切除术的患者及其复查信息，其中未复查患者115例（42.91%），已复查患者153例（57.09%）。单因素分析显示，患者来源（门诊比住院，χ2=5.68，P=0.017）、就诊科室（非消化内科比消化内科，χ2=6.64，P=0.010）、息肉数目（1个比2~4个比≥5个，χ2=7.32，P=0.026）影响结直肠息肉切除术后患者是否复查。Logistic回归分析结果显示，就诊于消化内科（P=0.039，OR=2.12，95%CI：1.04~4.34）、风险分级为3级（P=0.040，OR=1.92，95%CI：1.03~3.58）以及息肉数目≥5个（P=0.016，OR=2.89，95%CI：1.22~6.83）是影响患者是否复查的独立危险因素。结论 就诊于消化内科、风险分级为3级和息肉数目≥5个行结直肠息肉切除术的患者更有可能复查结肠镜。

Abstract:

Objective To explore status and influencing factors of surveillance in colorectal post-polypectomy patients. Methods Patients who underwent colorectal polypectomy in Renmin Hospital of Wuhan University between April 1, 2019 and June 30, 2019 were retrospectively studied. The surveillance information was obtained through electronic health record and telephone call. Status and influencing factors of surveillance in colorectal post-polypectomy patients were evaluated. Logistic regression model was used for multivariate analysis to determine independent risk factors influencing surveillance. Results A total of 268 colorectal post-polypectomy patients and their surveillance information were reviewed, of whom 153 (57.09%) patients received surveillance colonoscopy, and 115 (42.91%) patients did not. Univariate analysis showed that the source of patients (outpatients VS inpatients, χ2=5.68, P=0.017), department (others VS department of gastroenterology, χ2=6.64, P=0.010), and the number of polyps (1/(2~4)/≥5,χ2=7.32, P=0.026) influenced the outcome of surveillance. Logistic regression model indicated that department of gastroenterology (P=0.039, OR=2.12, 95%CI:1.04-4.34), risk level 3 (P=0.040,OR=1.92, 95%CI:1.03-3.58) and the number of polyps ≥5 (P=0.016, OR=2.89, 95%CI:1.22-6.83) were independent risk factors influencing surveillance. Conclusion Patients visit the department of gastroenterology or had a risk level 3 or ≥5 polyps are more likely to opt for surveillance following the procedure.