内镜下黏膜剥离术治疗消化道病变术后延迟出血危险因素分析  

Analysis of Risk Factors of Delayed Bleeding after Endoscopic Submucosal Dissection for Digestive Tract Lesions

作　　者：刘卫华 姜海波 Liu Weihua;Jiang Haibo(Department of Gastroenterology,The Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou,450000,Henan)

机构地区：[1]河南中医药大学第五临床医学院<郑州人民医院>消化内科,河南郑州450000

出　　处：《哈尔滨医药》2024年第1期89-91,共3页Harbin Medical Journal

摘　　要：目的探讨内镜下黏膜剥离术(ESD)治疗消化道病变术后延迟出血危险因素。方法回顾性分析160例接受ESD治疗的消化道病变患者的临床资料,分析患者相关临床、内镜及病理资料,按是否发生术后延迟出血分为出血组与未出血组,比较两组上述资料差异,总结ESD术后延迟出血的危险因素。结果两组患者年龄、性别、并发症、既往是否服用抗凝药物等比较差异无统计学意义(P>0.05)。出血组患者的病变大小与有表面溃疡占比高于未出血组(P<0.05)。两组患者整块切除情况比较(P>0.05);出血组的手术时间、术中明显出血占比高于未出血组(P<0.05)。病变大小、有表面溃疡、手术时间、术中明显出血均为影响消化道病变术后延迟出血的相关因素(P<0.05)。结论病变较大、有表面溃疡、手术时间长、术中明显出血的消化道病变患者术后迟发性出血风险较高,应及早处理。Objective To investigate the risk factors of delayed bleeding after endoscopic submucosal dissection(ESD)for digestive tract lesions.Methods Clinical data of 160 patients with digestive tract lesions treated with ESD were retrospectively analyzed,and relevant clinical,endoscopic and pathological data of the patients were analyzed.Patients were divided into bleeding group and non-bleeding group according to whether delayed bleeding occurred.The above data were compared between the two groups,and the risk factors of delayed bleeding after ESD were summarized.Results There was no significant difference between the two groups in terms of age,gender,complications,and whether they had taken anticoagulant drugs in the past(P>0.05).The size of lesions and the proportion of surface ulcers in bleeding group were higher than those in non-bleeding group(P<0.05).Total resection of the two groups was compared(P>0.05).The operation time and the proportion of obvious bleeding in the bleeding group were higher than those in the non-bleeding group(P<0.05).Lesion size,surface ulcers,operation time and obvious bleeding during operation were all related factors affecting delayed bleeding after digestive tract lesions(P<0.05).Conclusions Patients with digestive tract lesions with large lesions,surface ulcers,long operation time and obvious bleeding during operation have higher risk of postoperative delayed bleeding,and should be treated as soon as possible.

关 键 词：内镜下黏膜剥离术 消化道病变 延迟出血 

分 类 号：R734.2[医药卫生—肿瘤]