内镜黏膜下剥离术治疗胃间质瘤的临床效果及术后出血的危险因素分析

Clinical efficacy of endoscopic submucosal dissection in the treatment of gastric stromal tumor and risk factors of postoperative hemorrhage

摘要:

目的 探讨内镜黏膜下剥离术（ESD）治疗胃间质瘤的临床疗效及术后出血的危险因素。方法 选取2019年2月－2020年4月该院诊治的135例胃间质瘤作为研究对象，统计手术时间、术后进食时间、住院时间、术后出血、穿孔和感染发生率。根据患者ESD治疗后是否发生出血将患者进一步分为术后出血组（n = 12）和术后无出血组（n = 123）。采用Logistic回归分析胃间质瘤患者ESD术后出血的影响因素。结果 135例患者手术时间为（46.23±8.79）min，术后进食时间为（3.05±0.98）d，住院时间为（6.11±0.95）d，术后出血发生率为8.89%，术中穿孔发生率为0.74%，术后穿孔发生率为1.48%，术后感染发生率为7.41%。胃间质瘤患者ESD术后出血的独立危险因素有：高血压、糖尿病、血清降钙素原（PCT）、C反应蛋白（CRP）、血小板计数（PLT）。结论 高血压、糖尿病、PLT、血清PCT和CRP水平是胃间质瘤患者ESD术后出血的影响因素。

Abstract:

Objective To explore the clinical efficacy of endoscopic submucosal dissection (ESD) in the treatment of gastric stromal tumors and the risk factors for postoperative bleeding.Methods 135 cases of gastric stromal tumors diagnosed and treated from February 2019 to April 2020 were selected as the research subjects, and the operation time, postoperative eating time, hospital stay, postoperative bleeding, perforation and infection incidence were counted. According to whether bleeding occurred after ESD treatment, patients were further divided into 12 cases of postoperative bleeding group and 123 cases of postoperative non bleeding group. Logistic regression was used to analyze the influencing factors of bleeding after ESD in patients with gastric stromal tumors.Results The operation time of 135 patients was (46.23 ± 8.79) min, the postoperative eating time was (3.05 ± 0.98) days, the hospitalization time was (6.11 ± 0.95) days, the incidence of postoperative bleeding was 8.89%, and the incidence of intraoperative perforation 0.74%, the incidence of postoperative perforation was 1.48%, and the incidence of postoperative infection was 7.41%. Independent risk factors for bleeding after ESD in patients with gastric stromal tumors are: hypertension, diabetes, serum procalcitonin (PCT), C-reactive protein (CRP), platelet count (PLT).Conclusion Hypertension, diabetes, PLT, serum procalcitonin and C-reactive protein levels are the influencing factors of bleeding after ESD in patients with gastric stromal tumors.