胃镜下食管狭窄扩张术后出血的危险因素分析

Risk Factors of Bleeding after Esophageal Stricture Dilatation under Gastroscopy

目的:分析胃镜下食管狭窄扩张术后出血的危险因素。方法:以2017年6月-2018年12月我科收治的胃镜下食管狭窄扩张手术患者95例为研究样本,将出现术后出血症状的患者编入出血组,未出现出血症状的患者编入对照组。对患者的住院病历及检验资料进行调查,根据患者一般资料、实验室检查结果及影像学检查结果等资料开展单因素分析与多因素Logistic回归分析,确定术后出血的危险因素。结果:单因素分析结果表明两组患者的一般资料无明显差异(P>0. 05)。出血组的收缩压和心率均高于对照组,差异具有统计学意义(P<0. 05)。实验室检查结果无明显差异。根据多因素分析的结果,心率、血压、食管狭窄、食管癌、合并2个以上其他脏器疾病、手术治疗方式、治疗后食用坚硬食物、油腻食物及患者手术后的吸烟、酗酒等不良生活习惯为独立影响因素(P<0. 05)。结论:胃镜下食管狭窄扩张术后出血的危险因素具有多样化的特点。医护人员需要根据患者的实际情况,采用有针对性的干预措施。

Objective: To analyze the risk factors of bleeding after esophageal stricture dilatation under gastroscope. Methods: 95 patients with esophageal stenosis and dilatation under gastroscope from June 2017 to December 2018 were selected as study samples. The patients with bleeding symptoms after operation were divided into bleeding group and those without bleeding symptoms into control group. The inpatient medical records and examination data were investigated. Univariate analysis and multivariate logistic regression analysis were carried out based on the general data of patients,laboratory results and imaging findings to determine the risk factors of postoperative bleeding. Results: Univariate analysis showed that there was no significant difference in general data between the two groups( P>0. 05). The systolic blood pressure and heart rate of the bleeding group were higher than those of the control group( P<0. 05). According to the results of multivariate analysis,heart rate,blood pressure,esophageal stricture,esophageal cancer,combined with more than two other organ diseases,surgical treatment,use of hard food after treatment,greasy food,smoking and alcoholism after operation were independent influencing factors( P<0. 05).Conclusion: The risk factors of bleeding after esophageal stricture dilatation under gastroscope are various. Medical staff need to adopt targeted interventions according to the actual situation of patients.