目的:研究结直肠镜下结直肠腺瘤切除术后复发的影响因素。方法:选择青岛市市立医院2014年1月至2016年8月行结肠镜下结直肠腺瘤切除术且在切除术后3年内有结肠镜随访结果的患者501例。分析性别、年龄、BMI、是否吸烟、是否合并非酒精性脂肪性肝病(NAFLD)、是否合并糖尿病，腺瘤最大径、数量、病理类型，以及手术方式对患者术后腺瘤复发率的影响，将差异有统计学意义的结果纳入多因素logistic回归模型，分析腺瘤复发的独立危险因素。统计学方法采用卡方检验和多因素logistic回归分析。结果:501例结肠镜下结直肠腺瘤切除术患者术后3年的腺瘤复发率为25.5%(128/501)。腺瘤复发率在不同性别和年龄的患者间的差异均无统计学意义(n P均>0.05)。BMI为29 kg/mn 2的患者的腺瘤复发率分别为19.2%(32/167)、27.5%(44/160)和29.9%(52/174)，其中BMI>29 kg/mn 2者的腺瘤复发率高于BMI0.05)。吸烟、合并NAFLD、合并糖尿病的患者的腺瘤复发率分别高于不吸烟、不合并NAFLD、不合并糖尿病的患者[32.9%(51/155)比22.3%(77/346)、27.6%(61/221)比23.9%(67/280)、31.3%(25/80)比24.5%(103/421)]，差异均有统计学意义(n χ2＝8.132、7.232、6.874，n P均5～29 kg/mn 2 was higher than that of patients with BMI0.05). The recurrence rate of adenomas in patients who smoked, complicated with NAFLD or diabetes were higher than those of non-smokers, patients without NAFLD or diabetes (32.9%, 51/155 vs. 22.3%, 77/346; 27.6%, 61/221 vs. 23.9%, 67/280; 31.3%, 25/80 vs. 24.5%, 103/421), and the differences were statistically significant (n χ2=8.132, 7.232 and 6.874, all n P5 to <10, 10 to <20 and ≥20 mm were 11.6% (23/198), 18.5% (23/124), 41.7% (43/103) and 51.3% (39/76), respectively. The recurrence rates of adenomas in patients with a maximum diameter of 10 to 5 to <10 mm, and the differences were statistically significant (n χ2=35.990, 14.690, 49.440 and 23.650, all n P5 to <10 mm in maximam diameter, and between patients with adenomas of 10 to 0.05). The recurrence rates of adenomas in the patients with 1, 2 and ≥3 adenomas were 19.6% (20/102), 23.2% (46/198) and 30.8% (62/201), respectively. The recurrence rate of adenoma in patients with ≥3 adenomas was higher than that in patients with 1 adenoma, and the difference was statistically significant (n χ2=7.956, n P0.05). The recurrence rates of adenomas in the patients with progressive adenoma was higher than that of patients with non-progressive adenoma (28.8%, 98/340 vs. 18.6%, 30/161), and the difference was statistically significant (n χ2=8.539, n P<0.05). Among patients with adenoma diameter of 10 to <20 mm or ≥20 mm, the local recurrence rates of block resection (endoscopic piecemeal mucosal resection and endoscopic piecemeal submucosal dissection) group were higher than those of whole resection (endoscopic mucosal resection and endoscopic submucosal dissection) group (5/19 vs. 4.8%, 4/84; 45.7%, 16/35 vs. 14.6%, 6/41), and the differences were statistically significant (n χ2=9.027 and 8.868, both n P<0.05). The results of multivariate logistic regression analysis showed that maximum diameter of adenoma, number of adenoma, and pathological type of adenoma were all independent risk factors influencing adenoma recurrence (odds ratio=3.673, 1.532 and 1.989; 95% confidence interval 1.759 to 6.528, 1.096 to 2.897 and 1.564 to 4.089; alln P<0.05).n Conclusions:The recurrence rates after colorectal adenoma resection are higher in patients with high BMI, smoking, NAFLD and diabetes. The larger the maximum diameter, number and progression of the adenoma, the higher the recurrence rate of colorectal adenoma after resection. For the larger adenoma, the local recurrence rate of the patients receiving block resection is significantly higher than that of whole resection.