成人食管鱼刺异物并发症的相关危险因素

Risk factors for esophageal complications of ingestion of fish bones in adults

目的:探讨食管鱼刺异物的相关危险因素,尽量避免并发症的发生.方法:纳入在温岭市第一人民医院诊治的食管鱼刺异物患者76例,分析其并发症发生的情况,并从患者、鱼刺、鱼刺和食管壁的关系3个方面寻找相关危险因素.以并发症为因变量,相关影响因素为自变量,用二分类Logistic回归法进行分析.结果:46例患者(60.53%)有食管鱼刺相关并发症,其中糜烂23例(30.26%)、撕裂伤10例(13.16%)、溃疡8例(10.53%)、食管穿孔5例(6.58%).Logistic多因素回归分析显示鱼刺刺入食管壁、明显症状、强烈吞咽病史和鱼刺嵌顿时间≥24 h为并发症发生的相关危险因素(P<0.05).结论:鱼刺刺入食管壁、有明显症状的患者并发症的发生率会增高,避免强烈吞咽、尽早诊治可能会减少食管鱼刺异物的相关并发症的发生.

AIM： To determine the risk factors associated with esophageal complications of ingestion of fish bones in adults. METHODS： Seventy-five adult patients who had ingestion of fish bones were investigated at our hospital. The complications were analyzed and the risk factor for them were identified with regard to patient characteristics, fish bone characteristics and the relationship between fish bones and the esophageal wall. Binary Logistic regression was used to explore the associations between the potential risk factors（independent variables） and the complications（dependent variables）. RESULTS： Forty-six cases had complications associated with ingestion of fish bones, which included erosions（23, 30.26%）, lacerations（10, 13.16%）, ulcers（8, 10.53%）, and perforation（5, 6.58%）. Multivariate Logistic regression analysis showed that the esophageal wall being penetrated by fish bone, obvious symptoms, history of strong swallowing and duration of impaction ≥ 24 h were significant independent risk factors for complications（P 〈 0.05）. CONCLUSION： The risk for complications in patients with the esophageal wall being penetrated by fish bone or obvious symptoms is higher. In patients who have no history of strong swallowing or receive early diagnosis and treatment, the risk of complications is lower.