早期小肠镜干预对Peutz-Jeghers综合征患者的影响

Effect of early balloon assisted enteroscopy on patients with Peutz-Jeghers syndrome

目的明确早期气囊辅助内镜(小肠镜)干预对Peutz-Jeghers综合征(Peutz-Jeghers syndrome,PJS)患者的影响。方法回顾性分析2008年1月—2018年1月期间于空军特色医学中心(原空军总医院)行小肠镜下治疗的PJS患者为研究对象(284例),将其按是否因该疾病行外科手术治疗分为外科手术组(198例)和非外科手术组(86例),分别以"首次小肠镜干预年龄是否14岁以下"和"有无家族史"为暴露因素,对2组患者进行病例对照研究。结果 14岁前首次行小肠镜治疗较14岁后对PJS患者行外科手术治疗有统计学意义(χ~2=16.277,P<0.05),14岁前行小肠镜干预起保护性作用,可降低PJS患者外科手术治疗风险[OR=0.297,95%CI(0.164～0.535)]。有无家族史对PJS患者是否行外科手术治疗差异有统计学意义(χ~2=7.329,P<0.05),有家族遗传史者外科手术风险较散发者低,家族史起保护性作用,降低了PJS患者外科手术风险[OR=0.485,95%CI(0.287～0.818)]。14岁前小肠镜干预和家族史这两个变量无明显关联性(χ~2=3.672,P>0.05)。结论 Peutz-Jeghers综合征患者行早期小肠镜干预可以有效降低外科手术风险。

Objective To analyze the effect of early balloon assisted enteroscopy on patients with Peutz-Jeghers syndrome(PJS).Methods The clinic data of 284 patients with Peutz-Jeghers syndrome treated with enteroscopy at Air Force Medical Center from January 2008 to January 2018 was retrospectively analyzed.These patients were divided into two groups:the surgical intervention group and non-surgical intervention group."Undergoing enteroscopic intervention before 14 years old"and"family history"were chosen as exposure factors in this study,and statistical analysis was performed.Results The first Enteroscopic treatment before 14 years old had statistical significance compared with the surgical treatment after 14 years old(χ^2=16.277,P<0.05).The protective effect of Enteroscopic intervention before 14 years old can reduce the risk of surgical treatment for PJS patients[OR=0.297,95%CI(0.164-0.535)].There was significant difference between family history and surgical treatment for PJS patients(χ^2=7.329,P<0.05).Patients with family history had lower surgical risk than sporadic patients.Family history played a protective role and reduced the surgical risk of PJS patients[OR=0.485,95%CI(0.287-0.818)].There was no significant correlation between Enteroscopic intervention and family history before 14 years old(χ^2=3.672,P>0.05).Conclusion Early balloon assisted enteroscopic intervention on patients with Peutz-Jeghers syndrome can effectively reduce the risk of surgical operation.