摘要
Abstract
Objective:To investigate the incidence and influencing factors of delayed bleeding in patients with early gas-tric cancer(EGC)undergoing endoscopic submucosal dissection(ESD).Methods:A total of 210 EGC patients treated with ESD at the gastroscopy room of Nanchong Mental Health Center Affiliated to North Sichuan Medical College were consec-utively enrolled as study participants between January 2021 and March 2024.General and clinical data of the patients were collected,and delayed bleeding occurring within 30 days postoperatively was monitored and promptly managed.The inci-dence of delayed bleeding following ESD was calculated.Patients were then divided into two groups based on the occurrence of delayed bleeding.A logistic regression model was used to analyze the influencing factors associated with delayed bleeding in EGC patients following ESD.Results:A total of 210 EGC patients were included,comprising 230 lesions.Delayed bleeding occurred in 28 patients and 29 lesions after ESD,with an incidence rate of 13.3％(28/210).Multivariate logistic regression analysis revealed that the following were independent risk factors for delayed bleeding after ESD in EGC patients:preoperative use of anticoagulant and/or antiplatelet drugs(OR=5.205,95％CI:2.310～11.728,P＜0.001),surgical time ≥60 minutes(OR=3.174,95％CI:1.298～7.763,P=0.011),intraoperative bleeding(OR=7.773,95％CI:2.876～21.005,P＜0.001),preoperative biopsy frequency＞2 times(OR=6.620,95％CI:2.885～15.191,P＜0.001),and flat lesion morphology(OR=4.167,95％CI:1.404～12.361,P=0.010).Conclusion:Preoperative use of anticoag-ulant and/or antiplatelet drugs,surgical time≥60 minutes,intraoperative bleeding,preoperative biopsy frequency＞2 times,and flat lesion morphology are independent risk factors for delayed bleeding after ESD in EGC patients.Intervention strategies should be implemented in clinical practice to address the aforementioned factors and reduce the incidence of de-layed postoperative bleeding.关键词
早期胃癌/内镜黏膜下剥离术/迟发性出血/影响因素/Logistic回归模型Key words
Early gastric cancer/Endoscopic submucosal dissection/Delayed bleeding/Influencing factors/Logistic re-gression model分类
医药卫生
