早期胃癌内镜黏膜下剥离术后出血危险因素的Meta分析

Risk factors of post-endoscopic submucosal dissection bleeding in treatment of early gastric cancer: a Meta analysis

摘要:

目的 分析早期胃癌（EGC）内镜黏膜下剥离术后出血（PEB）的危险因素。方法 搜索中国知网、万方、维普数据库、中国生物医学文献数据库、PubMed、Embase、谷歌学术、Cochrane Library和Web of Science等数据库中关于EGC发生PEB的文章，使用纽卡斯尔-渥太华量表（NOS）对获取的文献进行质量评价。结果 共纳入9篇文献，研究对象5 719例，发生PEB 282例（4.93%）。Meta分析结果显示：男性（OR＾：1.73，95%CI：1.26～2.37）、溃疡阳性（OR＾：1.83，95%CI：1.04～3.22）、抗血栓类药物（OR＾：2.17，95%CI：1.65～2.86）、操作时间（MD：12.48，95%CI：1.72～23.23）、病灶切除大小（MD：5.30，95%CI：3.32～7.29）和浸润深度（OR＾：1.53，95%CI：1.04～2.26）是EGC发生PEB的危险因素。结论 男性、术中发现溃疡阳性、使用抗血栓类药物、操作时间、病灶切除大小和浸润深度是EGC发生PEB的独立危险因素，尤其是使用抗血栓类药物治疗的患者，要引起足够的重视。

Abstract:

Objective To analyze the risk factors of post-endoscopic submucosal dissection bleeding (PEB) in treatment of early gastric cancer.Methods CNKI, Wanfang, VIP, CBM, PubMed, Embase, Google Academic, Cochrane Library, Web of Science and other articles on early gastric cancer PEB were used to evaluate the quality of the obtained literatures using Newcastle-Ottawa scale (NOS).Results 5 719 subjects were included in 9 studies, with 282 (4.93%) cases of PEB. Meta results showed that male (OR＾: 1.73, 95%CI: 1.26 ~ 2.37), ulcer-positive (OR＾: 1.83, 95%CI: 1.04 ~ 3.22), antithrombotic drugs (OR＾: 2.17, 95%CI: 1.65 ~ 2.86), operation time (MD: 12.48, 95%CI: 1.72 ~ 23.23), size of resection lesion (MD: 5.30, 95%CI: 3.32 ~ 7.29) and infiltration depth (OR＾: 1.53, 95%CI: 1.04 ~ 2.26) were statistically significant, which were risk factors for the occurrence of early gastric cancer PEB.Conclusion Male, positive intraoperative ulcer, antithrombotic drugs, operation time, resection size of lesion and infiltration depth were independent risk factors for early gastric cancer PEB, especially for patients treated with antithrombotic drugs, enough attention should be paid.