消化道肿瘤患者内镜黏膜下剥离术术后迟发性出血发生危险因素分析及其护理指导价值  

Risk Factors of Delayed Bleeding after Endoscopic Submucosal Dissection in Patients with Gastrointestinal Tumors and Its Nursing Guiding Value

作　　者：廖一航 冯少馨[1] 陈丽娟[1] LIAO Yihang;FENG Shaoxin;CHEN Lijuan(Department of Gastroenterology,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院消化内科,福州350001

出　　处：《中国医药指南》2024年第36期13-16,共4页Guide of China Medicine

摘　　要：目的探究消化道肿瘤患者内镜黏膜下剥离术(ESD)术后迟发性出血发生危险因素分析及其护理指导价值。方法选取2022年11月至2023年8月我院收治的124例采用ESD治疗消化道肿瘤患者,其中术后迟发性出血患者30例,未发生迟发性出血患者94例,通过Logistics进行术后迟发性出血发生危险因素分析,并对护理指导价值展开进一步研究。结果长期使用抗血栓药物、活检次数≥3次、病变大小≥3 cm、浸润至黏膜下层、术中有明显出血、手术者经验例数均为消化道肿瘤患者ESD术后迟发性出血危险因素(P<0.05),通过护理指导后发现,22例消化道肿瘤ESD术后迟发性出血患者于术后3 d发现,8例术后4~6 d发现,且止血治疗后好转人数为30例,无出血性休克。结论ESD术后迟发性出血发生受多种危险因素影响,护理指导可有效改善术后迟发性出血。Objective To explore the risk factors of delayed bleeding after endoscopic submucosal dissection(ESD)in patients with gastrointestinal tumors and its nursing guidance value.Methods A total of 124 patients with gastrointestinal tumors treated with ESD in our hospital from November 2022 to August 2023 were selected,including 30 patients with postoperative delayed bleeding and 94 patients without delayed bleeding.The risk factors of postoperative delayed bleeding were analyzed by Logistics,and the value of nursing guidance was further studied.Results The long-term use of antithrombotic drugs,the number of biopsies≥3 times,the size of lesions≥3 cm,infiltration to submucosa,obvious bleeding during operation,and the number of experienced cases were the risk factors of delayed bleeding after ESD in patients with gastrointestinal tumors(P<0.05),22 patients with delayed bleeding after ESD of gastrointestinal tumors were found 3 days after operation,8 cases were found 4-6 days after operation,and 30 patents improved after hemostatic treatment,without hemorrhagic shock.Conclusions The occurrence of delayed bleeding after ESD is affected by many risk factors.Nursing guidance can effectively improve the delayed bleeding after ESD,which has popularization value.

关 键 词：消化道肿瘤 内镜黏膜下剥离术 术后迟发性出血 危险因素 护理指导 

分 类 号：R735[医药卫生—肿瘤] R473.73[医药卫生—临床医学]