在食道的内镜下膜剖析和类固醇应用后,狭窄的预测因素
Qing-Xia Wang1, Yuan Ding1, Qi-Liu Qian1
1Department of Gastroenterology, Southeast University Affiliated Zhongda Hospital, Medical School, Nanjing 210009, Jiangsu Province, China.
World journal of gastrointestinal endoscopy
|October 1, 2024
概括
在内镜下粘膜切割 (ESD) 后预测食道狭窄至关重要. 较小的病变周长和氨酸注射预测在类固醇预防后狭窄风险较低.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 手术创新 在外科创新.
背景情况:
- 内镜下粘膜切割 (ESD) 是早期食道癌的关键治疗方法.
- 食道狭窄是ESD后常见的并发症,即使使用类固醇预防也会影响高达45%的患者.
- 预测狭窄风险可以指导个性化治疗策略.
研究的目的:
- 为了确定ESD后食道狭窄形成的预测因子,使用类固醇预防.
- 改进患有食道ESD的患者的风险分层.
主要方法:
- 对120名接受食道ESD和类固醇预防的患者进行了回顾性分析.
- 进行了单变量和多变量逻辑回归分析.
- 评估的因素包括病变特征和下注射剂.
主要成果:
- 损伤周长小于5/6 (OR=0.19) 和氨酸下粘膜注射 (OR=0.15) 被确定为减少食道狭窄风险的独立预测因素.
- 这些发现在逻辑回归分析中具有意义 (分别P=0.02和P=0.03).
结论:
- 类固醇预防在预防ESD后食道狭窄方面是有效的.
- 损伤周长和酸注射是狭窄形成的关键独立预测因素.
- 高风险患者可能会从标准类固醇预防之外的额外干预中受益.
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