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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。
Objective: To investigate the risk factors for bleeding after endoscopic mucosal dissection (ESD) of gastric stromal tumors. Methods: The clinical data of 124 patients with gastric stromal tumor treated by ESD at Wuhan University People’s Hospital from February 2011 to May 2017 were analyzed retrospectively. Univariate and multivariate non-conditional logistic regression analysis was used to analyze the difference Risk factors for bleeding. Results: Of the 124 patients enrolled, 10 (8.06%) had postoperative bleeding. Logistic regression analysis showed that the history of cirrhosis, coronary heart disease, old cerebral infarction and atrial fibrillation were significantly related to the postoperative bleeding of gastric stromal tumors (all OR> 1, P <0.05). Further multivariate Logistic regression analysis showed that patients with cirrhosis, coronary heart disease, old cerebral infarction and atrial fibrillation were independent risk factors for gastric stromal tumor after ESD (all OR> 1, P <0.05). Conclusions: The history of liver cirrhosis, coronary heart disease, old cerebral infarction and atrial fibrillation are the risk factors for postoperative bleeding in patients with gastrointestinal stromal tumor (ESD) after surgery. Patients with these risk factors should be optimized for preoperative assessment, preoperative preparation and postoperative management, To reduce postoperative bleeding rate.