十二指肠占位性病变内镜黏膜下剥离术后延迟出血的危险因素分析

Risk factors of delayed bleeding after endoscopic submucosal dissection treatment for duodenal mass lesions

回顾性分析内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗的55例十二指肠占位性病变的临床资料,采用单因素分析、多因素非条件Logistic回归分析,明确十二指肠占位性病变发生延迟性出血的危险因素。5例(9.09%)发生延迟性出血。发生延迟性出血组和未发生延迟性出血组在内镜下未采取闭合治疗(P=0.035)方面差异具有统计学意义。多因素非条件Logistic回归分析显示内镜下未采取闭合治疗(P=0.029,OR=0.079,95%CI:0.008~0.776)是十二指肠占位性病变ESD术后延迟性出血的独立危险因素。提示年龄≥60岁及内镜下未采取闭合治疗患者,其ESD术后延迟性出血发生率较高,其中内镜下未采取闭合治疗与术后延迟性出血直接相关。

Data of 55 patients with duodenal mass lesions treated by endoscopic submucosal dissection(ESD)were retrospectively analyzed.Risk factors of delayed bleeding after ESD were explored by univariate analysis and multivariate unconditional logistic regression analysis.Duodenal delayed bleeding occurred in 5 patients(9.09%).No closure treatment under endoscopy(P=0.035)was significantly different between the delayed bleeding group and the non-delayed bleeding group.Multivariate non-conditional logistic regression showed no closure treatment under endoscopy was an independent risk factor for delayed bleeding after ESD in duodenal mass lesions(P=0.029,OR=0.079,95%CI:0.008-0.776).Patients older than 60 years and who did not take endoscopic closure treatment have higher incidences of delayed bleeding after ESD.No closure treatment under endoscopy is directly related to postoperative delayed bleeding.