剪切关闭长度是内镜乳头切除术后延迟出血的关键因素:一项回顾性多中心队列研究
Yuki Fujii1, Kazuyuki Matsumoto2, Kiyoaki Ochi3
1Department of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan.
Therapeutic advances in gastroenterology
|March 19, 2025
概括
透视乳头切除术 (EP) 可以导致出血. 切除部位的预防性剪切关闭是有效的,其关闭率为65%或更高,可显著减少EP后延迟出血.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 手术并发症 手术并发症
背景情况:
- 输血是内镜乳头切除术 (EP) 后经常出现的一种不良事件.
- 已知切除部位的预防性剪切关闭可减少EP后出血.
- 为了防止延迟出血,剪切关闭的最佳长度尚不清楚.
研究的目的:
- 为了确定EP后切除部位的最佳剪切长度,以防止延迟出血.
- 为了确定与EP后延迟出血相关的风险因素.
主要方法:
- 在130名接受EP的患者中进行了多中心回顾性队列研究.
- 基于剪切关闭长度的延迟出血频率的分析.
- 接收器运行特征曲线分析以确定最佳的关闭长度率.
- 多变量分析以确定延迟出血的危险因素.
主要成果:
- 延迟出血发生在17%的患者中,在没有切割 (28%) 和切割 (11%) 患者中发生的比率更高.
- 在剪切患者中,延迟出血更频繁,闭合率<65% (25%) 与>=65% (6%) 相比.
- 关闭率<65%被确定为延迟出血的重要危险因素 (OR,6.3;P=.030).
结论:
- 剪切关闭有效地防止了EP后延迟出血.
- 切除部位的闭合长度率为65%或以上,显著降低了延迟出血的发生率.
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