贲门部病变内镜黏膜下剥离术治疗后延迟出血的相关因素分析

摘要

[目的]探讨内镜黏膜下剥离术(ESD)治疗贲门部病变发生延迟出血的相关因素.[方法]回顾性分析行ESD治疗的197例贲门部病变患者的临床资料,探讨ESD治疗贲门部病变延迟出血的发生率及相关因素.[结果]贲门部病变197例ESD后发生延迟出血18例.术后延迟出血的发生与服用抗凝药物史、病变大小、术中并发症的发生、手术时间、创面处理方式、病理类型、饮食及活动控制均密切相关(P＜0.05).[结论]贲门部病变ESD后延迟出血的风险受多种因素的共同影响,对于较大的贲门部病变更应予以高度重视,术前全面综合的分析,术中精准操作、个体化治疗,术后严密观察可减少延迟出血的发生.%[Objective]To evaluate the risk factors of delayed bleeding after endoscopic submucosal dissection for cardia submucosal lesion.[Methods]Clinical data of 197 patients with cardia submucosal lesion treated with endoscopic submucosal dissection were collected from march 2008 to march 2016 retrospectively and the risk factors of delayed bleeding after the procedure were analyzed.[Results]Delayed bleeding occurred in eighteen patients.The occurrence of delayed bleeding closely associated with a history of taking anticoagulant drugs,the lesion size,intraoperative complications,operation time,wound treatment ways,pathological type,postoperative diet and activities of patients(P＜0.05).[Conclusion]The occurrence of delayed bleeding is affected by various factors.Intensive care should be paid to the large cardia lesion,preoperative comprehensive analysis,intraoperative precise operation and individualized treatment since it can decrease the occurrence of delayed bleeding.