早期食管癌患者内镜下黏膜剥离术后延迟性出血的危险因素分析  

Risk Factors of Delayed Bleeding After Endoscopic Mucosal Dissection in Patients with Early Esophageal Cancer

作　　者：丁娟 曹名波 马志杰 DING Juan;CAO Mingbo;MA Zhijie(Henan People's Hospital,Zhengzhou,450000)

机构地区：[1]河南省人民医院,郑州大学人民医院,450000

出　　处：《实用癌症杂志》2022年第7期1144-1146,共3页The Practical Journal of Cancer

摘　　要：目的探讨早期食管癌内镜下黏膜剥离术(ESD)后延迟性出血的高危因素。方法回顾性分析早期食管癌患者216例的临床资料,所有入选者均顺利完成ESD治疗。术后对患者进行随访,根据患者是否发生延迟性出血分为发生组与未发生组。统计两组临床资料,分析早期食管癌患者ESD术后延迟性出血的危险因素。结果216例早期食管癌患者经ESD治疗后,20例发生延迟性出血,发生率为9.26%(20/216);发生组年龄≥60岁、肿瘤直径≥3 cm、术中出血、浸润深度(M3)占比均高于未发生组,差异有统计学意义(P<0.05);两组性别、基础疾病、肿瘤位置、术中使用肾上腺素、病理分类、抗凝或抗血小板药物使用史等对比,差异无统计学意义(P>0.05);Logistic回归分析:年龄≥60岁、肿瘤直径≥3 cm、术中出血、浸润深度(M3)是早期食管癌患者ESD术后延迟性出血的独立危险因素(P<0.05且OR≥1)。结论早期食管癌患者ESD术后易发生延迟性出血,年龄≥60岁、肿瘤直径≥3 cm、术中出血、浸润深度(M3)是其独立危险因素,临床需予以高度重视。Objective To investigate the high risk factors of delayed bleeding after endoscopic mucosal dissection(ESD)in the treatment of early esophageal cancer.Methods Clinical data of 216 cases of early esophageal cancer were analyzed retrospectively.All the selected patients successfully completed ESD treatment.The patients were followed up after operation.According to whether the patients had delayed bleeding,they were divided into occurrence group and non occurrence group.The clinical data of the 2 groups were counted,including gender,age,basic disease,tumor location,tumor diameter,intraoperative bleeding,intraoperative use of epinephrine,pathological classification,use history of anticoagulant or antiplatelet drugs,and the risk factors of delayed bleeding after ESD in patients with early esophageal cancer were analyzed.Results After ESD treatment,20 cases of delayed bleeding occurred in 216 patients with early esophageal cancer,the incidence rate was 9.26%(20/216);The age≥60 years old,tumor diameter≥3cm,intraoperative bleeding and depth of invasion(M3)in the occurrence group were significantly higher than those in the non occurrence group(P<0.05);There was no significant difference between the 2 groups in gender,basic disease,tumor location,intraoperative use of epinephrine,pathological classification,history of anticoagulant or antiplatelet drugs(P>0.05);Logistic regression analysis:age≥60 years old,tumor diameter≥3cm,intraoperative bleeding and depth of invasion(M3)were independent risk factors for delayed bleeding after ESD in patients with early esophageal cancer(P<0.05 and or≥1).Conclusion patients with early esophageal cancer are prone to delayed bleeding after ESD.Age≥60 years old,tumor diameter≥3 cm,intraoperative bleeding and depth of invasion(M3)are independent risk factors,which should be paid great attention in clinic.

关 键 词：早期食管癌 内镜下黏膜剥离术 延迟性出血 危险因素 

分 类 号：R735.1[医药卫生—肿瘤]