关键词: 结肠息肉, 病房, 并发症, 经济学,  , 医学

Abstract: Objective  To study the complications，relative risk factors and economic efficiency ratio in patients undergoing endoscopic resection of colorectal polyps (polyps) with different perioperative treatment scheme.Methods  A retrospective analysis was conducted on  1 720  endoscopic polyp patients admitted to our hospital from December  2015 to December  2018,  and according to the random number table method,  the patients were divided into inpatient group(588 cases，performed selective operation after perfect inspection),  patients with only routine blood tests performed resection directly were divided into two subgroups,  daycare group(659 cases，postoperative admission to daycare ward)，and outpatient group(473 cases，postoperative followup observation outside the hospital).  The incidence of complications,  related risk factors,  bed use and cost were analyzed.Results  The postoperative fever in the inpatient group was higher than the other two groups (P<0.01). Abdominal discomfort was the lowest in the outpatient group with statistically significant difference compared with the other two groups (P<0.01). The outpatient group was followed by the day care group, and there was tatistically significant difference between day care group and inpatient group (P<0.05). The outpatient group had the least intestinal function recovery time and hypoglycemic reaction, and the difference was statistically significant compared with the other two groups(P<0.05 or P<0.01). Intraoperative bleeding in ascending colon and ileocecal junction was the most common,  followed by rectum.Delayed polypectomy bleedingin rectumwas the most common,followed by ascending colon and ileocecal junction. The risk of bleeding increased with the increase of adaxial polyp diameter,  the risk of bleeding with pedicle or apically raised polyp in the range of 1.02.0 cm was the highest,  while in the range that＞2.0 cm was the lowest,  especially with delayed polypectomy bleeding,  which was significantly different compared with oter types (P<0.01). Age significantly increased the risk of bleeding,  followed by systolic blood pressure level and polyp diameter,  while high diastolic blood pressure level,  surgical history and general anesthesia were protective factors for bleeding risk.Conclusion  Polyp endoscopic therapy performed in outpatient department did not increase the risk of complications,  only highrisk groups need day care wards,  which is beneficial for improving patients'  satisfication and compliance with endoscopic review,  saving medical insurances and reducing medical costs.

Key words: colonic polyps, patients&rsquo, rooms, complications;economics, medical