ESD治疗食管早癌术后发生延迟性出血的Logistic回归分析  

Logistic regression analysis for delayed bleeding after esophageal cancer

作　　者：李倩 班志超 LI Qian;BAN Zhichao(Department of Gastroenterology,The Second Central Hospital of Baoding City,Hebei,Baoding 072750,China)

机构地区：[1]河北省保定市第二中心医院消化内科,072750

出　　处：《河北医药》2022年第13期1957-1961,共5页Hebei Medical Journal

摘　　要：目的 内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)作为一种新型的临床应用前景较好的治疗技术在食管早癌(early stage esophageal carcinoma,ESEC)的临床治疗中已逐渐成熟,关于其术后延迟性出血发生的危险因素在国外有所涉猎,但国内全鲜有报道,且样本量小,故本文从临床预防的角度探析ESD治疗ESEC后延迟性出血发生的危险因素,为ESEC的临床诊治提供理论与实践依据。方法 选取2017年1月至2019年1月收治的活检病理为ESEC患者88例(2 cm≤病变长度≤6 cm)作为研究对象,回顾性分析临床资料,用非条件Logistic回归分析引起延迟性出血的相关因素。结果 多因素Logistic回归分析发现,ESEC患者ESD术后发生延迟性出血的危险因素主要是组织类型(腺瘤)、切除病变的平均时间、病变大小(2.0~6.0 cm)、生长方式(隆起型病变)、病变部位、基础病变,其OR值分别为2.341、1.247、4.251、1.256、1.257、2.924。结论 ESEC患者ESD术后诱发延迟性出血的危险因素相对较多,应针对这些危险因素制定行之有效的措施进行干预,减少并发症,提高生存率。Objective To investigate the risk factors of occurrence of delayed bleeding of early stage esophageal carcinoma(ESEC)after endoscopic submucosal dissection(ESD),so as to provide theoretical and practical basis for the clinical diagnosis and treatment of ESEC.Methods A total of 88 patientas with ESEC(2cm≤lesion length≤6cm)who were treated by ESD in our hospital from January 2017 to January 2019 were enrolled in the study.The clinical data and the related risk factors of occurrence of delayed bleeding after operation were analyzed by unconditional Logistic regression.Results Multivariate Logistic regression analysis showed that the main risk factors of occurrence of delayed bleeding after ESD were tissue type(adenoma),mean time of resection,lesion size(2.0~6.0cm),growth pattern(protuberant lesion),lesion location and underlying lesion,with the OR values being 2.341,1.247,4.251,1.256,1.257 and 2.924,respectively.Conclusion There are many risk factors for occurrence of delayed bleeding after ESD in patients with ESEC,therefore,it is necessary to perform effective measures to decrease the incidence of complications and improve the survival rate of patients.

关 键 词：内镜黏膜下剥离术 食管早癌 延迟性出血 危险因素 

分 类 号：R571[医药卫生—消化系统]