消化道异物滞留并发症的危险因素分析

Analysis of risk factors and selection of treatment methods for complications of gastrointestinal foreign body entrapment retention

目的:探讨消化道异物滞留并发症危险因素及治疗方法的选择。方法:本研究为病例对照研究,选取2014年3月至2024年5月联勤保障部队第九九一医院消化内科收治的378例消化道异物患者,男209例,女169例,年龄(65.02±10.06)岁,年龄范围为13~82岁。根据有无并发症分为并发症组( n=43)与无并发症组( n=335)。比较两组患者的年龄、性别、异物类型、滞留部位、滞留时间、症状,分析并发症发生的相关因素,采用多因素回归模型分析消化道异物并发症的危险因素。 结果:异物以尖锐型异物居多[66.7%(252/378)],常见的滞留部位为食管上段[38.6%(146/378)],43例患者发生并发症。多因素回归分析表明,年龄≥60岁( OR=0.483,95 CI:0.287~0.812),尖锐型异物( OR=0.524,95 CI:0.312~0.878)、食管上段异物( OR=2.277,95 CI:1.336~3.881)、滞留时间>24 h( OR=0.481,95 CI:0.275~0.842)均为消化道异物并发症的独立危险因素( P<0.05)。 结论:消化道异物如不正规处理可引起严重并发症。年龄≥60岁、尖锐型异物、食管上段异物及滞留时间>24 h的患者易出现并发症,建议尽早取出。

ObjectiveTo explore the risk factors and treatment methods for complications of foreign body retention in the digestive tract.MethodsThis study was a case-control study,a total of 378 patients were selected from the department of Gastroenterology of 991st Hospital of People′s Liberation Army Joint Logistics Support Force from March 2014 to May 2024,including 209 males and 169 females,aged(65.02±10.06)years old,the age ranging from 13 to 82 years old.A random number table was used to divide patients into complication group(n=43)and non complication group(n=335).Collect and compare two groups of age,gender,foreign body types,retention sites,retention time and symptoms,and analyze the relevant factors for the occurrence of complications,Use a multiple regression model to analyze the risk factors for complications of gastrointestinal foreign bodies.ResultsThe majority of foreign body types in this group were sharp[66.7%(252/378)],and the most retention sites was the upper esophagus[38.6%(146/378)],with 43 cases experienced complications.Multivariate regression analysis showed that,aged≥60 years old(OR=0.483,95 CI:0.287 to 0.812),with sharp foreign bodies(OR=0.524,95 CI:0.312 to 0.878),upper esophageal foreign bodies(OR=2.277,95 CI:1.336 to 3.881),retention time>24 h(OR=0.481,95 CI:0.275 to 0.842)were the influencing factors for the occurrence of complications.ConclusionsIrregular treatment the foreign bodies in the digestive tract can cause serious complications.Patients aged≥60 years old,with sharp foreign bodies,upper esophageal foreign bodies,and retention time>24 h are prone to complications.It is recommended to remove them as early as possible.