食管异物就诊时间对临床预后的影响

Effect of visiting time on clinical outcomes in patients with esophageal foreign bodies

目的探讨食管异物就诊时间对于患者并发症发生率、住院费用、住院时间的影响，为指导患者及时治疗提供理论依据。方法回顾性分析2010年6月至2017年6月于鼓楼医院住院治疗的130例食管异物患者，根据就诊时间分为A组（就诊时间≤24h）以及B组（就诊时间〉24h），对相关临床特征（性别、年龄、嵌顿部位、异物种类、并发症、治疗方法、住院时间以及住院费用等）进行统计学分析。结果2组中异物种类均以鱼骨为主[40．0％（20／50），50．0％（40／80）]，其他包括猪骨、鸡骨、义齿、枣核等，2组异物嵌顿部位均以食管上中段为主[98．0％（49／50），96．3％（77／80）]，下段少见。B组与A组相比，并发症发生率明显增高[61．3％（49／80）比36．0％（18／50）]，住院费用明显增多[（1．28±1．14）万元比（0．77±0．92）万元]，住院时间明显延长[（9．06±10．08）d比（5．22±3．32）d]，差异均有统计学意义（P〈0．05）。结论食管异物在24h内进行有效的治疗，可以减少并发症的发生，减少住院费用并缩短住院时间。

Objective To investigate the effect of visiting time on the incidence of complications, hospital expenses and stays, and to provide theoretical basis for the timely treatment of patients with esophageal foreign bodies. Methods Data of 130 patients with diagnosis of esophageal foreign bodies in the Drum Tower Hospital from June 2010 to June 2017 were retrospectively studied. The patients were divided into two groups （Group A, visiting time ≤ 24 hours; Group B, visiting time〉24 hours）according to duration from ingestion to effective treatment. Clinical features including gender, age, locations and types of foreign bodies, complications, therapeutic methods, hospitalization stays and costs were analyzed. Results The most common foreign bodies that were swallowed were fish bones in both groups [ 40. 0% （20/50） , 50.0% （40/80） ] , followed by pig and chicken bones, dentures and jujube pips. Foreign bodies commonly blocked the upper and middle esophageal tract [ 98. 0% （49/50）, 96. 3% （77/80）], but rarely the lower esophageal tract. Compared with group A, the incidence of complications [ 61.3% （49/80） VS 36.0% （ 18/ 50） ], hospitalization expenses （1.28±1.14 thousand yuan VS 0.77±0. 92 thousand yuan）, and stays （9.06 ± 10.08 d VS 5.22 ± 3.32 d） of group B were significantly higher （all P 〈 0.05）. Conclusion Treatment within 24 hours results in fewer complications, less costs and shorter postoperative hospitalization stays for patients with esophaged foreign bodies.