胃间质瘤内镜下黏膜剥离术后出血的危险因素分析  

Analysis of risk factors for bleeding after endoscopic submucosal dissection for gastric gastrointestinal stromal tumors

作　　者：杨厚涞 王琦[1] 孙华文[1] 王秋爽[1] 孙科明 

机构地区：[1]武汉大学人民医院胃肠外一科,湖北武汉430060

出　　处：《中国普通外科杂志》2017年第10期1304-1309,共6页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(81170368)

摘　　要：目的:探讨胃间质瘤内镜下黏膜剥离术(ESD)后出血的危险因素。方法:回顾性分析武汉大学人民医院2011年2月—2017年5月124例胃间质瘤行ESD治疗患者的临床资料,采用单因素及多因素非条件Logistic回归分析胃间质瘤ESD术后出血的危险因素。结果:纳入的124例患者中,10例(8.06%)发生术后出血。单因素Logistic回归分析结果显示,肝硬化、冠心病、陈旧性脑梗塞、房颤病史与胃间质瘤ESD术后出血明显有关(均OR>1,P<0.05)。进一步多因素Logistic回归分析表明,与肝硬化、冠心病、陈旧性脑梗塞、房颤病史是胃间质瘤ESD术后的独立危险因素(均OR>1,P<0.05)。结论:肝硬化、冠心病、陈旧性脑梗塞、房颤病史为胃间质瘤ESD术后出血的危险因素,对于这些危险因素的患者应优化术前评估,加强术前准备与术后管理,以降低术后出血率。Objective： To investigate the risk factors for bleeding after of gastric gastrointestinal stromal tumor （GIST）. endoscopic submucosal dissection （ESD） in treatment Methods： The clinical data of 124 patients with gastric GIST undergoing ESD from February 2011 to in Renmin Hospital of Wuhan University were retrospectively analyzed. The risk factors for hemorrhage May 2017 after ESD for gastric GIST were determined by univariate and multivariate unconditional logistic regression analysis. Results： Of the 124 patients enrolled, postoperative bleeding occurred in 10 cases （8.06%）. Results of the univariate logistic regression analysis showed that histories of liver cirrhosis, coronary heart disease, old brain infarcts and atrial fibrillation were significantly associated with bleeding after ESD for gastric GIST （all OR〉 1, P〈0.05）; further multivariate logistic regression analysis disease, old brain infarcts and atrial fibrillation were GIST （all OR〉1, P〈0.05）. revealed that histories of liver cirrhosis, coronary heart independent risk factors for bleeding after ESD for gastricConclusion： The histories of liver cirrhosis, coronary heart disease, old brain infarcts and atrial fibrillation are risk factors for bleeding after ESD for gastric GIST. Therefore, the preoperative assessment should be optimized and the pre- and postoperative management should be enhanced in patients with these risk factors, so as to reduce the incidence of postoperative bleeding.

关 键 词：胃肠道间质肿瘤 胃 手术后出血 危险因素 

分 类 号：R735.2[医药卫生—肿瘤]