早期食管癌及癌前病变ESD术后并发延迟性出血的相关风险因素

Analysis of Safety Factors Related to Risk of Delayed Bleeding After ESD Operation for Early Esophageal Cancer and Precancerous Lesions

目的探讨早期食管癌(EC)及癌前病变内镜黏膜下剥离术(ESD)术后并发延迟性出血的相关风险因素。方法回顾性分析行ESD治疗的86例早期EC及癌前病变患者临床资料,分析ESD术后并发延迟性出血的相关危险因素。结果早期EC及癌前病变ESD术后并发延迟性出血率9.30%(8/86)。单因素分析显示:病变深度、肿瘤大小、术中出血量与早期EC及癌前病变ESD术后并发延迟性出血有关(P<0.05),年龄、性别、合并糖尿病、使用抗凝药物、肿瘤位置、病理类型与早期EC及癌前病变ESD术后并发延迟性出血无关(P>0.05);多因素分析显示:黏膜下层病变、肿瘤大小≥3 cm、术中出血量≥800 mL是早期EC及癌前病变ESD术后并发延迟性出血的高危因素(P<0.05)。结论早期EC及癌前病变ESD术后并发延迟性出血受肿瘤大小、病变深度、术中出血量影响,临床须加以重视。

Objective To investigate the safety factors related to the risk of delayed bleeding after endoscopic submucosal dissection(ESD)for early esophageal cancer(EC)and precancerous lesions.Methods The clinical data of 86 patients with early EC and precancerous lesions treated with ESD were retrospectively analyzed.The literature factors related to delayed bleeding after ESD operation was analyzed.Results The delayed bleeding rate for early EC and precancerous lesions after ESD operation was 9.30%(8/86);univariate analysis showed that lesion depth,tumor size and intraoperative blood loss were related to delayed bleeding after ESD for early EC and precancerous lesions,and the difference was statistically significant(P<0.05);age,gender,combined diabetes,use of anticoagulant drugs,tumor location and pathological type were not related to delayed bleeding after ESD for early EC and precancerous lesions,and there was no statistical significance(P>0.05);multivariate analysis showed that submucosal lesions,tumor size≥3cm,intraoperative blood loss≥800mL were the risk factors for delayed bleeding after ESD for early EC and precancerous lesions(P<0.05).Conclusion Delayed bleeding after ESD for early EC and precancerous lesions is affected by tumor size,lesion depth and intraoperative bleeding volume.Clinical attention must be paid to it.