早期胃癌内镜黏膜下剥离术后出血危险因素的Meta分析  

Risk factors of post-endoscopic submucosal dissection bleeding in treatment of early gastric cancer:a Meta analysis

作　　者：赵祥禄 管鑫[1] 陈融 姜相君[1] 曲海霞[1] Xiang-lu Zhao;Xin Guan;Rong Chen;Xiang-jun Jiang;Hai-xia Qu(Department of Gastroenterology,Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao,Shandong 266011,China)

机构地区：[1]青岛大学附属青岛市市立医院消化内二科,山东青岛266011

出　　处：《中国内镜杂志》2022年第3期50-57,共8页China Journal of Endoscopy

基　　金：青岛市科技惠民示范引导专项(No:20-3-4-44-nsh)。

摘　　要：目的分析早期胃癌(EGC)内镜黏膜下剥离术后出血(PEB)的危险因素。方法搜索中国知网、万方、维普数据库、中国生物医学文献数据库、PubMed、Embase、谷歌学术、Cochrane Library和Web ofScience等数据库中关于EGC发生PEB的文章,使用纽卡斯尔-渥太华量表(NOS)对获取的文献进行质量评价。结果共纳入9篇文献,研究对象5719例,发生PEB 282例(4.93%)。Meta分析结果显示:男性(O^R:1.73,95%CI:1.26~2.37)、溃疡阳性(O^R:1.83,95%CI:1.04~3.22)、抗血栓类药物(O^R:2.17,95%CI:1.65~2.86)、操作时间(MD:12.48,95%CI:1.72~23.23)、病灶切除大小(MD:5.30,95%CI:3.32~7.29)和浸润深度(O^R:1.53,95%CI:1.04~2.26)是EGC发生PEB的危险因素。结论男性、术中发现溃疡阳性、使用抗血栓类药物、操作时间、病灶切除大小和浸润深度是EGC发生PEB的独立危险因素,尤其是使用抗血栓类药物治疗的患者,要引起足够的重视。Objective To analyze the risk factors of post-endoscopic submucosal dissection bleeding(PEB)in treatment of early gastric cancer.Methods CNKI,Wanfang,VIP,CBM,PubMed,Embase,Google Academic,Cochrane Library,Web of Science and other articles on early gastric cancer PEB were used to evaluate the quality of the obtained literatures using Newcastle-Ottawa scale(NOS).Results 5719 subjects were included in 9 studies,with 282(4.93%)cases of PEB.Meta results showed that male(O^R:1.73,95%CI:1.26~2.37),ulcer-positive(O^R:1.83,95%CI:1.04~3.22),antithrombotic drugs(O^R:2.17,95%CI:1.65~2.86),operation time(MD:12.48,95%CI:1.72~23.23),size of resection lesion(MD:5.30,95%CI:3.32~7.29)and infiltration depth(O^R:1.53,95%CI:1.04~2.26)were statistically significant,which were risk factors for the occurrence of early gastric cancer PEB.Conclusion Male,positive intraoperative ulcer,antithrombotic drugs,operation time,resection size of lesion and infiltration depth were independent risk factors for early gastric cancer PEB,especially for patients treated with antithrombotic drugs,enough attention should be paid.

关 键 词：危险因素 早期胃癌 内镜黏膜下剥离术后出血 META分析 

分 类 号：R735.2[医药卫生—肿瘤]