摘要
[目的]探讨内镜黏膜下剥离术(ESD)治疗结直肠病变术后发热的危险因素。[方法]回顾性分析行结直肠ESD的347例患者的临床资料,对病例的年龄、性别、既往病史、病变位置、病变大小、病理、术中不良事件、ESD操作时长、术后创面处理、围术期抗生素使用情况、ESD后住院时间、术后不良事件等进行单因素及多因素分析,总结术后发热的危险因素。[结果]347例患者术后发热率为4.6%(16/347),发热最高体温(38.1±0.4)℃,发热天数(2.6±1.5)d。通过单因素及多因素分析,术中出血或术中穿孔(OR=0.481,95%CI=0.267~0.867,P=0.015)、术后迟发出血或迟发穿孔(OR=0.323,95%CI=0.105~0.991,P=0.048)以及病灶累及固有肌层(OR=0.320,95%CI=0.143~0.716,P=0.006)是结直肠EDS后发热的独立危险因素。[结论]术中出血或术中穿孔、术后迟发出血或迟发穿孔以及病灶累及固有肌层是结直肠EDS后发热的独立危险因素,应给予此类患者更多的观察及处理,以期降低术后发热率。
[Objective]Explore the risk factors of fever after endoscopic submucosal dissection(ESD)in the treatment of colorectal Lesions.[Methods]The clinical data of 347 patientsreceiving colorectal ESD were enrolled.The age,gender,previous medical history,lesion location,lesion size,pathology report,intra-operative adverse events,ESD operation time,postoperative wound treatment,perioperative antibiotic use,hospital stay after ESD and postoperative adverse events were analyzed by single and multiple factors,and the risk factors of postoperative fever were summarized.[Results]Post-ESD fever developed in 16 patients(4.6%).The highest temperature was(38.1±0.4)℃,the duration of fever was(2.6±1.5)d.Through sin-gle factor and multiple factor analysis,intraoperative bleeding or perforation(OR=0.481,95%CI=0.267-0.867,P=0.015),postoperative bleeding or perforation(OR=0.323,95%CI=0.105-0.991,P=0.048),lesion with deep invasion of the muscularis propria(OR=0.320,95%CI=0.143-0.716,P=0.006),were the relevant risk factors for postoperative fever.[Conclusion]Intraoperative bleeding or perforation,post-operative bleeding or perforation and lesion with deep invasion of the muscularis propria,are the relevant risk factors for postoperative fever of colorectal ESD.Attention should be given to these patients in order to reduce the postoperative fever rate.
作者
芦家明
于红刚
LU Jia-ming;YU Hong-gang(Department of Gastroenterology,Renmin Hospital of Wuhan University,430060 Wuhan,China)
出处
《临床消化病杂志》
CAS
2023年第6期453-458,共6页
Chinese Journal of Clinical Gastroenterology
关键词
结直肠
内镜黏膜下剥离术
发热
危险因素
colorectal
endoscopic submucosal dissection
fever
risk factors
