1.广东医科大学第一临床医学院消化内科,广东 湛江 524023
2.东莞市第八人民医院消化内科,广东 东莞 523000
Received:10 February 2025,
Published:25 November 2025
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柴芳时,范文伟,梁卓妮等.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):968-971.
CHAI Fang-shi,FAN Wen-wei,LIANG Zhuo-ni,et al.Analysis of influencing factors of delayed bleeding after endoscopic gastric polypectomy in antithrombotic patients[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):968-971.
柴芳时,范文伟,梁卓妮等.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):968-971. DOI: 10.11659/jjssx.02E025039.
CHAI Fang-shi,FAN Wen-wei,LIANG Zhuo-ni,et al.Analysis of influencing factors of delayed bleeding after endoscopic gastric polypectomy in antithrombotic patients[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):968-971. DOI: 10.11659/jjssx.02E025039.
目的
2
探讨抗栓患者内镜下胃息肉切除术后迟发性出血的影响因素。
方法
2
采用回顾性病例对照研究,选取2021年4月至2024年4月于东莞市第八人民医院抗栓治疗期间接受内镜下胃息肉切除术并出现术后迟发性出血的42例患者为出血组,选取同期在接受相同手术后未出现迟发性出血的84例患者作为未出血组。对比2组患者一般资料、息肉及抗栓治疗情况。采用条件
Logistic
回归分析探讨抗栓患者内镜下胃息肉切除术后迟发性出血的影响因素,并通过受试者工作特征(
ROC
)曲线进行预测价值评估。
结果
2
出血组患者息肉最大径大于未出血组(
P
<
0.05)。2组患者术前抗血栓药物数量、抗栓药物管理情况对比,差异有统计学意义(
P
<
0.05)。
Logistic
回归分析显示,术前息肉最大径较大(
OR
=4.056,95%
CI
:2.116~7.775)、术前使用多种抗栓药物(
OR
=5.308,95%
CI
:1.516~18.583)、停用所有抗栓药物但接受肝素替代治疗(
OR
=7.167,95%
CI
:1.921~26.734)为术后迟发性出血的危险因素(
P
<
0.05)。
ROC
曲线分析显示,术前息肉最大径较大、使用多种抗栓药物、停用所有抗栓药物但接受肝素替代治疗预测术后迟发性出血的曲线下面积分别为0.882(95%
CI
:0.812~0.932)、0.702(95%
CI
:0.614~0.781)、0.746(95%
CI
:0.661~0.820)。
结论
2
术前息肉最大径较大、术前使用多种抗栓药物、接受肝素替代治疗是抗栓患者内镜下胃息肉切除术后迟发性出血的危险因素。
Objective
2
To explore the influencing factors of delayed bleeding after endoscopic gastric polypectomy in antithrombotic patients.
Methods
2
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
2
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 su
rgery, 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
2
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.
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