Risk Factors and Predictive Value of Delayed Bleeding after Mucosal Dissection of Gastrointestinal Lesions in Patients with Early Gastrointestinal Tract Cancer
LI Ruini
WANG Shasha
JIA Zebo
WEI Xiaojie
WANG Teng
Abstract：Objective To study the risk factors and predictive value of delayed bleeding after mucosal dissection of digestive tract lesions in patients with early gastrointestinal cancer.Methods 108 patients with early gastrointestinal tract cancer received by Xianyang city central hospital from May 2022 to May 2024 were retrospectively selected for observation,and underwent gastrointestinal lesion mucosal dissection respectively,and were grouped according to whether delayed hemor-rhage occurred in the postoperative period,and those who occurred were included in the DPPB group and those who did not were included in the non-DPPB group,and clinical data of the two groups were compared,and those with differences in the in-fluence of the univariate analysis were included in logistic regression.The factors were included in logistic regression for analy-sis to obtain the risk factors for delayed bleeding after mucosal dissection of digestive tract lesions in patients with early gastro-intestinal tract cancer,and the value of each factor in predicting delayed bleeding after surgery was also analyzed by drawing a column line graph and a calibration curve.Results A total of108 patients with early gastrointestinal tract cancer were includ-ed in this paper,statistically,a total of 21 cases of delayed bleeding occurred after surgery,with an incidence rate of 19.44％,which were included in the DPPB group,and the remaining 87 cases (80.56％),who did not occur,were included in the non-DPPB group.There was a significant difference in the maximum diameter of the lesion,the section size,the operation time,the depth of infiltration,the degree of fibrosis,and the APTT between the DPPB group and the non-DPPB group,differ-ences (P<0.05).Whether delayed hemorrhage occurred after mucosal dissection of digestive tract lesions was taken as the dependent variable,and the maximum diameter of the lesion,slice size,operation time,infiltration depth,fibrosis degree,and APTT were taken as the independent variables X1,X2,X3,X4,X5,and X6,and the corresponding assignments were carried out for each of the independent variables,respectively.After the diagnosis of covariance,the VIF values of section size and operation time were 15.315 and 14.411,respectively,with a tolerance of 0.065 and 0.069,which indicated that the two items had a covariance problem (VIF value>5),and it could be considered to move them out of the model and then analyze them again.After logistic regression analysis,the maximum diameter of the lesion,the depth of infiltration,the degree of fi-brosis,and APTT were all influential factors for delayed bleeding after mucosal stripping of digestive tract lesions(P<0.05).Based on these results,a column-line diagram model for predicting the risk of delayed bleeding after mucosal dissection of di-gestive tract lesions was constructed,and a calibration curve was plotted at the same time,and it was found that the calibration curve of the column-line diagram model for predicting delayed bleeding after mucosal dissection of digestive tract lesions was close to the ideal curve.Conclusion The risk of delayed bleeding after mucosal dissection of digestive tract lesions in pa-tients with early gastrointestinal tract cancer may be related to the risk factors such as the maximum diameter of the lesion,the depth of infiltration,the degree of fibrosis,APTT,etc.At the same time,there is a certain value of the factors in predicting the delayed bleeding after the operation,which is worth to be popularized and used in the clinic.
Keywords：Early gastrointestinal tract cancerMucosal dissection of gastrointestinal tract lesionsDelayed hemorrhageLine drawing
Publication Date：2024-07-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 895-901 )