患有末期脏病的患者经过结肠镜多样性切除术后出血的危险因素
Jung Hyun Ji1, Hyun Woo Kim1, Jihye Park1
1Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Surgical endoscopy
|December 11, 2023
概括
末期病 (ESRD) 患者接受结肠镜多斑切除术时面临出血风险. 晚年,较大的多体 (>7mm) 和内镜粘膜切除增加了立即多切除术后出血 (IPPB) 的风险.
科学领域:
- 胃肠病学 胃肠病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内镜检查是指内镜检查.
背景情况:
- 在末期病 (ESRD) 患者的结肠镜多斑切除术后,关于出血风险的数据有限.
- 这项研究旨在确定ESRD中多片切除术后出血 (PPB) 的发生率和危险因素.
- PPB包括即时和延迟的出血事件.
研究的目的:
- 调查末期脏疾病 (ESRD) 患者的多斑切除术后出血 (PPB) 的发生率.
- 在ESRD中识别患者和多相关的风险因素,即时的多切除术后出血 (IPPB).
- 为了确定IPPB风险增加的最佳聚大小值.
主要方法:
- 92名接受结肠镜多斑切除术的ESRD患者的回顾性审查 (2005年9月 - 2020年6月).
- 后勤回归分析以确定直接PPB (IPPB) 的风险因素.
- 接收器操作特征 (ROC) 分析,以确定IPPB风险的最佳聚大小切割值.
主要成果:
- 立即PPB (IPPB) 发生在26.1%的患者和16.1%的息肉中;延迟PPB发生在2.2%中.
- 对IPPB的独立风险因素包括聚大小>7mm,年龄>70岁和内镜粘膜切除 (EMR).
- 高IPPB风险的最佳聚大小切割值是7mm (AUC=0.755).
结论:
- 在ESRD患者的结肠镜多角切除术需要谨慎.
- IPPB的主要风险因素包括晚年 (>70岁),多体大小>7mm和EMR.
- 风险分层可以指导ESRD患者更安全的多面切除手术程序.
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