局解手术学杂志2025，Vol.34Issue(11)：968-972,5.DOI:10.11659/jjssx.02E025039
抗栓患者内镜下胃息肉切除术后迟发性出血的影响因素分析
Analysis of influencing factors of delayed bleeding after endoscopic gastric polypectomy in antithrombotic patients
摘要
Abstract
Objective To explore the influencing factors of delayed bleeding after endoscopic gastric polypectomy in antithrombotic patients.Methods A retrospective case-control study was conducted,42 patients who experienced delayed bleeding after endoscopic gastric polypectomy during antithrombotic therapy at Dongguan Eighth People's Hospital from April 2021 to April 2024 were selected as the bleeding group,and 84 patients who underwent the same surgery during the same period without delayed postoperative bleeding were selected as the non-bleeding group.The general data,polyps and antithrombotic treatment of the two groups were compared.The influencing factors of delayed bleeding after endoscopic gastric polypectomy in patients with antithrombotic treatment were analyzed by conditional Logistic regression,and the predictive value was evaluated by the receiver operating characteristic(ROC)curve.Results The maximum polyp diameter of the bleeding group was larger than that of the non-bleeding group(P<0.05).There were significant differences in the number of antithrombotic drugs and the management of antithrombotic drugs between the two groups(P<0.05).Logistic regression analysis showed that the large maximum polyp diameter before surgery(OR=4.056,95%CI:2.116 to 7.775),the use of multiple antithrombotic drugs before surgery(OR=5.308,95%CI:1.516 to 18.583),and the withdrawal of all antithrombotic drugs but the application of renal replacement therapy(OR=7.167,95%CI:1.921 to 26.734)were the risk factors for postoperative delayed bleeding(P<0.05).ROC curve showed the area under the curve of the large maximum polyp diameter before surgery,the use of multiple antithrombotic drugs before surgery,and the withdrawal of all antithrombotic drugs but the application of renal replacement therapy for predicting postoperative delayed bleeding were 0.882(95%CI:0.812 to 0.932),0.702(95%CI:0.614 to 0.781)and 0.746(95%CI:0.661 to 0.820).Conclusion The large maximum polyp diameter before surgery,preoperative use of multiple antithrombotic drugs,and the application of renal replacement therapy are influencing factors for delayed bleeding after endoscopic gastric polypectomy in antithrombotic patients.关键词
胃息肉切除术/内镜黏膜下剥离术/抗栓治疗/术后迟发性出血/肝素替代治疗Key words
gastric polypectomy/endoscopic submucosal dissection/antithrombotic therapy/postoperative delayed bleeding/renal replacement therapy分类
医药卫生引用本文复制引用
柴芳时,范文伟,梁卓妮,陈文峰..抗栓患者内镜下胃息肉切除术后迟发性出血的影响因素分析[J].局解手术学杂志,2025,34(11):968-972,5.基金项目
广东省医学科学技术研究基金项目(B2022319) （B2022319）
