临床研究(Clinical Research)

胃间质瘤内镜下黏膜剥离术后出血的危险因素分析

Published at: 2017年第26卷第10期

杨厚涞 1 , 王琦 1 , 孙华文 1 , 王秋爽 1 , 孙科明 1
1 武汉大学人民医院 胃肠外一科,湖北 武汉 430060
通讯作者 琦 王 Email: qiw@whu.edu.cn
DOI: 10.3978/j.issn.1005-6947.2017.10.013
基金:
国家自然科学基金资助项目 81170368

摘要

目的: 探讨胃间质瘤内镜下黏膜剥离术(ESD)后出血的危险因素。方法:回顾性分析武汉大学人民医院2011年2月—2017年5月124例胃间质瘤行ESD治疗患者的临床资料,采用单因素及多因素非条件Logistic回归分析胃间质瘤ESD术后出血的危险因素。结果:纳入的124例患者中,10例(8.06%)发生术后出血。单因素Logistic回归分析结果显示,肝硬化、冠心病、陈旧性脑梗塞、房颤病史与胃间质瘤ESD术后出血明显有关(均OR>1,P<0.05)。进一步多因素Logistic回归分析表明,与肝硬化、冠心病、陈旧性脑梗塞、房颤病史是胃间质瘤ESD术后的独立危险因素(均OR>1,P<0.05)。结论:肝硬化、冠心病、陈旧性脑梗塞、房颤病史为胃间质瘤ESD术后出血的危险因素,对于这些危险因素的患者应优化术前评估,加强术前准备与术后管理,以降低术后出血率。


Analysis of risk factors for bleeding after endoscopic submucosal dissection for gastric gastrointestinal stromal tumors

Abstract

Objective: To investigate the risk factors for bleeding after endoscopic submucosal dissection (ESD) in treatment of gastric gastrointestinal stromal tumor (GIST). Methods: The clinical data of 124 patients with gastric GIST undergoing ESD from February 2011 to May 2017 in Renmin Hospital of Wuhan University were retrospectively analyzed. The risk factors for hemorrhage after ESD for gastric GIST were determined by univariate and multivariate unconditional logistic regression analysis. Results: Of the 124 patients enrolled, postoperative bleeding occurred in 10 cases (8.06%). Results of the univariate logistic regression analysis showed that histories of liver cirrhosis, coronary heart disease, old brain infarcts and atrial fibrillation were significantly associated with bleeding after ESD for gastric GIST (all OR>1, P<0.05); further multivariate logistic regression analysis revealed that histories of liver cirrhosis, coronary heart disease, old brain infarcts and atrial fibrillation were independent risk factors for bleeding after ESD for gastric GIST (all OR>1, P<0.05). Conclusion: The histories of liver cirrhosis, coronary heart disease, old brain infarcts and atrial fibrillation are risk factors for bleeding after ESD for gastric GIST. Therefore, the preoperative assessment should be optimized and the pre- and postoperative management should be enhanced in patients with these risk factors, so as to reduce the incidence of postoperative bleeding.


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引用

引用本文: 厚涞 杨, 琦 王, 华文 孙, 秋爽 王, 科明 孙. 胃间质瘤内镜下黏膜剥离术后出血的危险因素分析[J]. 中国普通外科杂志, 2017, 26(10): 1304-1309.
Cite this article as: YANG Houlai, WANG Qi, SUN Huawen, WANG Qiushuang, SUN Keming . Analysis of risk factors for bleeding after endoscopic submucosal dissection for gastric gastrointestinal stromal tumors[J]. Chin J Gen Surg, 2017, 26(10): 1304-1309.