早期食管癌及癌前病变内镜治疗后并发症的影响因素分析

Analysis in influencing factors of complications in early esophageal cancer and precancerous lesions after endoscopic treatment

目的探讨早期食管癌及癌前病变患者内镜治疗后并发症的影响因素。方法选取行内镜治疗的268例早期食管癌或癌前病变患者作为研究对象,对其临床资料进行回顾性分析,并采用单因素和多因素Logistic回归分析对相关并发症的影响因素进行分析。结果 268例患者共发生并发症69例(总并发症发生率为25.75%),其中延迟出血11例(4.10%)、食管穿孔12例(4.48%)、食管狭窄46例(17.16%)。单因素和多因素Logistic回归分析显示,病变直径、病变周长是患者术后延迟出血的独立影响因素(P<0.05),手术方式是食管穿孔的独立影响因素(P<0.05),病变周长、手术时间是食管狭窄的独立影响因素(P<0.05)。结论早期食管癌和癌前病变患者接受内镜治疗后易发生延迟出血、食管穿孔和食管狭窄,其中延迟出血的独立影响因素为病变直径、病变周长,食管穿孔的独立影响因素为手术方式,食管狭窄的独立影响因素为病变周长、手术时间。手术医师应根据并发症的影响因素采取相应预防措施,从而改善患者的预后和生活质量。

Objective To explore the influencing factors of complications in early esophageal cancer and precancerous lesions after endoscopic treatment. Methods A total of 268 patients with early esophageal cancer or precancerous lesions who underwent endoscopic treatment were selected as research objects, their clinical data were retrospectively analyzed, and the influencing factors of related complications were analyzed by univariate and multivariate Logistic regression analysis. Results A total of 69 cases(with the overall complication rate of 25.75%) of 268 patients had complications, including delayed bleeding in 11 cases(4.10%), esophageal perforation in 12 cases(4.48%), and esophageal stenosis in 46 cases(17.16%). Univariate and multivariate Logistic regression analysis showed that lesion diameter and lesion circumference were independent influential factors of delayed postoperative bleeding(P<0.05), surgical method was independent influential factors of esophageal perforation(P<0.05), lesion circumference and operative time were independent influential factors of esophageal stenosis(P<0.05). Conclusion Patients with early esophageal cancer and precancerous lesions are prone to occur delayed bleeding, esophageal perforation and esophageal stenosis after endoscopic treatment, among which the independent influencing factors of delayed bleeding are lesion diameter and lesion circumference, the independent influencing factors of esophageal perforation are lesion circumference and operative time. In order to improve the prognosis and quality of life of patients, surgeons should take corresponding preventive measures according to the influencing factors of complications.