Analysis of the influencing factors of bleeding after endoscopic submucosal dissection in patients with early gastric cancer treated with antithrombotic therapy
Objective To analyze the influencing factors of bleeding after endoscopic submucosal dissection(ESD)in patients with early gastric cancer treated with antithrombotic therapy.Methods The clinical data of 40 patients with early gastric cancer who underwent ESD in the background of antithrombotic therapy in Zhangjiakou First Hospital,Hebei Province from January 2016 to December 2023 were retrospectively analyzed.According to the occurrence of bleeding after ESD,the patients were divided into non-bleeding group(34 cases)and bleeding group(6 cases).The incidence of bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy was counted.Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of bleeding.Results The incidence of bleeding after ESD was 15.0％(6/40)in 40 patients with early gastic cancer treated with antithrombotic therapy.Univariate analysis showed that tumor size,lesion depth and intraoperative blood loss were associated with postoperative bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy(all P＜0.05).Age,gender,diabetes mellitus and pathological type were not associated with postoperative bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy(all P＞0.05).The statistically significant factors(lesion depth,tumor size,intraoperative blood loss)in univariate analysis were included in Logistic multivariate analysis.The results showed that tumor size≥3 cm,submucosal lesions,intraoperative blood loss≥800 ml were risk factors for bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy(the odds ratios were 7.001,6.802,11.101;and the 95％confidence intervals were 1.502-32.592,1.464-31.615,and 1.931-63.852,respectively;all P＜0.05).Conclusion The bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy is affected by tumor size,lesion depth and intraoperative blood loss,which should be paid attention to in clinical practice.In order to reduce the risk of bleeding,careful consideration of antithrombotic therapy should be given in the preoperative evaluation and postoperative management.
Early gastric cancerEndoscopic submucosal dissectionAntithrombotic therapyRisk of bleeding
万方数据
维普
