上消化道异物的临床特点及其并发症的危险因素分析

发布时间：2018-11-16 11:21

【摘要】：目的:总结上消化道异物的临床特点并分析其所致并发症的相关危险因素。方法:回顾性分析2015年1月-2016年12月期间宁夏回族自治区人民医院四个院区(总院、西夏分院、宁南分院、急救中心)因上消化道异物就诊患者的临床资料,并总结其临床特点:1.年龄、性别、症状、吞入异物的原因、并存消化道疾病;2.异物的类型、大小、数量、位置,边缘是否锐利;3.异物存在的时间、取异物所用时间、所用器械、并发症发生情况、死亡率、行外科手术的病例数。通过logistic回归分析来研究并发症发生的相关危险因素。结果:1.上消化道异物类型依次见于:枣核(47.5%)、动物骨头(26.0%)、食物团块(15.5%)、药片包装(2.5%)、硬币(2.5%)、义齿(2.0%)、纽扣(1.5%)、塑料(1.0%)、金属条(1.0%)、钢丝(0.5%)。2.异物大小为32.98±11.35(6-80)mm;异物存在的位置依次见于食管上段(77.5%)、食管下段(9.0%)、食管中段(7.5%)、胃腔(6.0%)。3.200例上消化道异物通过内镜取出者198例,20例(10.0%)发生严重不等的并发症:穿孔9例(45%)、食管糜烂6例(30%)、食管溃疡4例(20%)、食管粘膜出血1例(5%)。其中2例因不能用内镜取出而行外科行手术治疗。4.通过logistic回归分析得出上消化道异物所致并发症的危险因素为:异物存在的时间"g12h(OR=9.04,95%CI:2.91-28.04;P=0.000)及边缘锐利(OR=7.95,95%CI:2.09-30.21;P=0.002)。结论:1.枣核是本地区最常见的异物类型;而食管为异物最常见的嵌顿部位,尤以食管上段为甚;2.异物存在的时间"g12h及其边缘锐利是上消化道异物导致并发症的危险因素,应综合评估后选择合适的治疗方案。
[Abstract]:Objective: to summarize the clinical features of upper gastrointestinal foreign bodies and analyze the risk factors of complications. Methods: the clinical data of four hospitals (General Hospital, Xixia Branch, Ningnan Branch, Emergency Center) of Ningxia Hui Autonomous region people's Hospital from January 2015 to December 2016 due to upper gastrointestinal tract foreign body were retrospectively analyzed. And summarize its clinical characteristics: 1. Age, sex, symptoms, causes of ingestion of foreign bodies, coexistence of digestive tract diseases; 2. The type, size, quantity, position, edge of the foreign body are sharp; 3. Time of existence of foreign body, time of taking foreign body, instruments used, occurrence of complications, mortality rate, number of cases undergoing surgery. The risk factors of complications were studied by logistic regression analysis. The result is 1: 1. The types of foreign bodies in upper digestive tract were as follows: jujube seed (47.5%), animal bone (26.0%), food mass (15.5%), pill packing (2.5%), coin (2.5%), denture (2.0%). Button (1.5%), plastic (1.0%), metal strip (1.0%), wire (0.5%). Foreign body size 32.98 卤11.35 (6-80) mm; The foreign bodies were found in the upper esophagus (77.5%), the lower esophagus (9.0%), the middle esophagus (7.5%) and the gastric cavity (6.0%). 3.200 cases of upper gastrointestinal foreign bodies were removed by endoscopy. Severe complications occurred in 20 cases (10.0%): perforation in 9 cases (45%), esophageal erosion in 6 cases (30%), esophageal ulcer in 4 cases (20%), and esophageal mucosal hemorrhage in 1 case (5%). Two of them were treated surgically because they could not be removed by endoscope. 4. By logistic regression analysis, the risk factors of complications caused by foreign bodies in upper digestive tract are as follows: time of existence of foreign bodies "g 12h (OR=9.04,95%CI:2.91-28.04;P=0.000) and edge sharpness (OR=7.95,95%CI:2.09-30.21;)." P0. 002). Conclusion: 1. Jujube nucleus is the most common type of foreign body in this area, and esophagus is the most common inlay of foreign body, especially in the upper part of esophagus. The time of existence of foreign bodies "g12h and sharp edge are the risk factors of complications caused by foreign bodies in upper digestive tract. The appropriate treatment should be selected after comprehensive evaluation."
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R57

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