摘要
目的分析影响早期胃癌患者行内镜黏膜下剥离术(ESD)后出血的危险因素。方法选择2018年3月—2019年8月南京大学医学院附属鼓楼医院消化内科收治早期胃癌且行ESD患者80例为研究对象,收集患者基本信息、临床病理特征、术后情况等;采用多因素Logistic回归分析患者术后出血的危险因素,采用Log-rank检验分析术后生存患者出血因素。结果80例患者中5例(6.25%)发生术后出血(出血组),75例未发生术后出血(未出血组);术后出血组氯吡格雷服药史和病变大小≥2 cm患者所占比例显著高于未出血组(χ^(2)/P=9.454/0.002,4.866/0.027);有氯吡格雷服药史和病变大小≥2 cm是早期胃癌患者发生术后出血的独立危险因素[OR=2.12(1.31~3.42)、5.07(2.75~9.11)];有氯吡格雷服药史和病变大小≥2 cm的患者,在行ESD术后的出血风险显著增高(χ^(2)/P=13.783/0.000、24.721/0.000)。结论有氯吡格雷服药史和病变大小≥2 cm与早期胃癌患者行ESD术后出血密切相关,应予以重点关注。
Objective To analyze the risk factors of bleeding after endoscopic submucosal dissection(ESD)in patients with early gastric cancer.Methods From March 2018 to August 2019,80 patients with early gastric cancer who were treated with ESD in the Department of Gastroenterology,Drum Tower Hospital,Nanjing University School of Medicine,were selected as the research objects,and the basic information of the patients,clinicopathological characteristics,postoperative conditions,etc.were collected.Multivariate logistic regression was used.The risk factors of postoperative bleeding were analyzed.Log rank test was used to analyze the bleeding factors of postoperative survival patients.Results Postoperative bleeding occurred in 5 of 80 patients(6.25%)(bleeding group)and 75 in non-bleeding group;the proportion of patients with clopidogrel medication history and lesion size≥2 cm in postoperative bleeding group was significantly higher than that in non-bleeding group(χ^(2)/P=9.454/0.002,4.866/0.027).History of taking clopidogrel and lesion size≥2 cm are independent risk factors for postoperative bleeding in patients with early gastric cancer[OR=2.12(1.31~3.42),5.07(2.75~9.11)].Patients with clopidogrel medication history and lesion size≥2 cm have a significantly higher bleeding risk after ESD(χ^(2)/P=13.783/0.000,24.721/0.000).Conclusion The history of taking clopidogrel and the size of lesions≥2 cm are closely related to bleeding after ESD in patients with early gastric cancer and should be paid attention to.
作者
蔡培
张妮娜
李雯
刘风
姜金鹏
Cai Pei;Zhang Nina;Li Wen;Liu Feng;Jiang Jinpeng(Digestive Endoscopy Center, Gulou Hospital, Nanjing University Medical College, Jiangsu Province,Nanjing 210008, China;不详)
出处
《疑难病杂志》
CAS
2021年第2期163-166,共4页
Chinese Journal of Difficult and Complicated Cases
基金
江苏省科学技术计划项目(BK20180119)。
关键词
早期胃癌
内镜黏膜下剥离术
术后出血
危险因素
Early gastric cancer
Endoscopic submucosal dissection
Postoperative bleeding
Risk factors
