本文關(guān)鍵詞： 內(nèi)鏡黏膜下剝離術(shù) 醫(yī)源性潰瘍 瘢痕愈合 危險(xiǎn)因素　出處：《石河子大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:分析胃粘膜病變行內(nèi)鏡下粘膜剝離術(shù)(ESD)后潰瘍愈合的相關(guān)危險(xiǎn)因素。方法:選取由于胃黏膜病變行胃ESD術(shù)55例患者,觀察手術(shù)時(shí)間、術(shù)中是否出血、手術(shù)部位,手術(shù)創(chuàng)面大小及術(shù)后6周胃鏡復(fù)查時(shí)潰瘍的大小、分期及潰瘍愈合率,進(jìn)行單因素和多因素Logistics回歸分析。采用SPSS 17.0統(tǒng)計(jì)學(xué)軟件包進(jìn)行統(tǒng)計(jì)分析。結(jié)果:患者平均手術(shù)創(chuàng)面直徑大小為24.5mm(14-60mm),術(shù)后6周潰瘍平均直徑大小4.6mm(0-10mm),平均手術(shù)時(shí)間為49.9min(11-150min),術(shù)中出現(xiàn)出血15例,術(shù)中出血率27.3%,出血患者經(jīng)術(shù)者于術(shù)中內(nèi)鏡下止血,術(shù)后禁食水、止血、補(bǔ)液等對(duì)癥處理后治愈。6周潰瘍愈合率為69.09%。對(duì)ESD術(shù)后6周潰瘍愈合的單因素Logistics回歸分析表明,手術(shù)創(chuàng)面大小、術(shù)中創(chuàng)面是否出血、病變病理分型(胃早癌)與術(shù)后潰瘍愈合顯著相關(guān)(P0.05);多因素Logistics回歸分析表明僅手術(shù)創(chuàng)面大小與潰瘍愈合顯著相關(guān)(p0.05)。結(jié)論:手術(shù)創(chuàng)面大小是影響ESD術(shù)后醫(yī)源性潰瘍愈合的重要影響因素。
[Abstract]:Objective: to analyze the risk factors of ulcer healing after endoscopic mucosal dissection (ESD). Methods: 55 patients with gastric mucosal lesions were treated with gastric ESD and the operative time was observed. Intraoperative bleeding, site of operation, size of surgical wound and ulcer size, stage and ulcer healing rate 6 weeks after operation. Univariate and multivariate Logistics regression analysis was performed. SPSS 17.0 statistical software package was used for statistical analysis. Results: the average diameter of surgical wound was 24.5 mm (P < 0.05). 14-60mm. The mean diameter of ulcer was 4.6mm / 10mm / min, the mean operation time was 49.9min / 11 ~ 150min / min, and the bleeding occurred in 15 cases. The bleeding rate during the operation was 27.3%. The bleeding patients were treated by endoscope, fasting water and hemostasis after operation. The healing rate of ulcer was 69.09. The univariate Logistics regression analysis of ulcer healing at 6 weeks after ESD showed that the size of the wound was small. Whether the wound was bleeding or not, the pathological type (early gastric cancer) was significantly related to the healing of postoperative ulcer (P0.05). Multivariate Logistics regression analysis showed that only surgical wound size was significantly correlated with ulcer healing (p0.05). Conclusion: the size of surgical wound is an important factor affecting the healing of iatrogenic ulcer after ESD.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R656.6

【參考文獻(xiàn)】

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本文編號(hào)：1444965