胃息肉内镜治疗患者迟发性出血发生的影响因素  

Influencing factors of delayed bleeding in patients with gastric polyps undergoing endoscopic treatment

作　　者：曹小东 CAO Xiaodong(Department of Gastroenterology,Second Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣南医学院第二附属医院消化内科,江西赣州341000

出　　处：《当代医学》2022年第24期25-28,共4页Contemporary Medicine

摘　　要：目的分析胃息肉(GP)内镜治疗患者发生迟发性出血的影响因素,为临床减少迟发性出血的发生提供参考依据。方法采用前瞻性随机实验方法选取2018年10月至2020年10月本院收治的60例GP内镜治疗患者作为研究对象,观察术后迟发性出血情况,统计患者临床资料[性别、年龄、体重指数(BMI)、基础疾病、病变部位、息肉形态、活检次数、长期使用非甾体抗炎药(NSAID)、停用抗血栓药物时间、息肉直径、术中出血量、手术时间、伴有溃疡或瘢痕、术中追加镇静剂、息肉切除方式],分析GP内镜治疗患者发生迟发性出血的影响因素。结果随访14 d,60例行GP内镜治疗的患者发生迟发性出血12例,占比20.00%;单因素及多因素Logistic回归分析显示,活检次数>2次、停用抗血栓药物时间较短、息肉直径较大均为GP内镜治疗患者迟发性出血的影响因素(OR>1,P<0.05)。结论活检次数>2次、停用抗血栓药物时间较短、息肉直径较大的GP内镜治疗患者发生迟发性出血的风险较高,可通过减少活检次数,延长停用抗血栓药物时间,提高操作技术等措施降低术后迟发性出血的发生率。Objective To analyze the influencing factors of delayed bleeding in patients with gastric polyp(GP)endoscopic treatment,and to provide reference for clinically reducing the occurrence of delayed bleeding.Methods A prospective randomized experimental method was used to select 60 patients with GP endoscopy who were treated in our hospital from October 2018 to October 2020 as the research subjects,the postoperative delayed bleeding was observed,and the clinical data(sex,age,body mass index[BMI],underlying disease,lesion location,polyp morphology,number of biopsies,long-term use of nonsteroidal anti-inflammatory agent[NSAID],discontinuation of using antithrombotic drug time,polyp diameter,intraoperative blood loss,operation time,accompanied by ulcer or scar,intraoperative additional sedative,polyp removal method)of patients,the influencing factors of delayed bleeding in patients treated with GP endoscopic therapy were analyzed.Results After 14 d of follow-up,12 of 60 patients who underwent GP endoscopic therapy developed delayed bleeding,accounting for 20.00%.Univariate and multivariate Logistic regression analysis showed that the number of biopsies was>2 times,and the time to stop antithrombotic drugs was shorter,polyp diameter and polyp diameter were the influencing factors of delayed bleeding in patients treated with GP endoscopic therapy(OR>1,P<0.05).Conclusion Patients with GP endoscopy with the number of biopsies was>2 times,and the time to stop antithrombotic drugs was shorter,polyp diameter and polyp diameter have higher risk of delayed bleeding,measures such as reducing the number of biopsy,prolonging the duration of discontinuation of antithrombotic drugs technology can reduce the incidence of postoperative delayed bleeding.

关 键 词：胃息肉 内镜 迟发性出血 活检 抗血栓药物 息肉直径 

分 类 号：R656.6[医药卫生—外科学]