胃ESD后溃疡愈合的影响因素分析

发布时间：2018-01-19 18:16

本文关键词： 内镜黏膜下剥离术医源性溃疡瘢痕愈合危险因素　出处：《石河子大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:分析胃粘膜病变行内镜下粘膜剥离术(ESD)后溃疡愈合的相关危险因素。方法:选取由于胃黏膜病变行胃ESD术55例患者,观察手术时间、术中是否出血、手术部位,手术创面大小及术后6周胃镜复查时溃疡的大小、分期及溃疡愈合率,进行单因素和多因素Logistics回归分析。采用SPSS 17.0统计学软件包进行统计分析。结果:患者平均手术创面直径大小为24.5mm(14-60mm),术后6周溃疡平均直径大小4.6mm(0-10mm),平均手术时间为49.9min(11-150min),术中出现出血15例,术中出血率27.3%,出血患者经术者于术中内镜下止血,术后禁食水、止血、补液等对症处理后治愈。6周溃疡愈合率为69.09%。对ESD术后6周溃疡愈合的单因素Logistics回归分析表明,手术创面大小、术中创面是否出血、病变病理分型(胃早癌)与术后溃疡愈合显著相关(P0.05);多因素Logistics回归分析表明仅手术创面大小与溃疡愈合显著相关(p0.05)。结论:手术创面大小是影响ESD术后医源性溃疡愈合的重要影响因素。
[Abstract]:Objective: to analyze the risk factors of ulcer healing after endoscopic mucosal dissection (ESD). Methods: 55 patients with gastric mucosal lesions were treated with gastric ESD and the operative time was observed. Intraoperative bleeding, site of operation, size of surgical wound and ulcer size, stage and ulcer healing rate 6 weeks after operation. Univariate and multivariate Logistics regression analysis was performed. SPSS 17.0 statistical software package was used for statistical analysis. Results: the average diameter of surgical wound was 24.5 mm (P < 0.05). 14-60mm. The mean diameter of ulcer was 4.6mm / 10mm / min, the mean operation time was 49.9min / 11 ~ 150min / min, and the bleeding occurred in 15 cases. The bleeding rate during the operation was 27.3%. The bleeding patients were treated by endoscope, fasting water and hemostasis after operation. The healing rate of ulcer was 69.09. The univariate Logistics regression analysis of ulcer healing at 6 weeks after ESD showed that the size of the wound was small. Whether the wound was bleeding or not, the pathological type (early gastric cancer) was significantly related to the healing of postoperative ulcer (P0.05). Multivariate Logistics regression analysis showed that only surgical wound size was significantly correlated with ulcer healing (p0.05). Conclusion: the size of surgical wound is an important factor affecting the healing of iatrogenic ulcer after ESD.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656.6

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