【摘要】：目的:總結上消化道異物的臨床特點并分析其所致并發(fā)癥的相關危險因素。方法:回顧性分析2015年1月-2016年12月期間寧夏回族自治區(qū)人民醫(yī)院四個院區(qū)(總院、西夏分院、寧南分院、急救中心)因上消化道異物就診患者的臨床資料,并總結其臨床特點:1.年齡、性別、癥狀、吞入異物的原因、并存消化道疾病;2.異物的類型、大小、數(shù)量、位置,邊緣是否銳利;3.異物存在的時間、取異物所用時間、所用器械、并發(fā)癥發(fā)生情況、死亡率、行外科手術的病例數(shù)。通過logistic回歸分析來研究并發(fā)癥發(fā)生的相關危險因素。結果:1.上消化道異物類型依次見于:棗核(47.5%)、動物骨頭(26.0%)、食物團塊(15.5%)、藥片包裝(2.5%)、硬幣(2.5%)、義齒(2.0%)、紐扣(1.5%)、塑料(1.0%)、金屬條(1.0%)、鋼絲(0.5%)。2.異物大小為32.98±11.35(6-80)mm;異物存在的位置依次見于食管上段(77.5%)、食管下段(9.0%)、食管中段(7.5%)、胃腔(6.0%)。3.200例上消化道異物通過內鏡取出者198例,20例(10.0%)發(fā)生嚴重不等的并發(fā)癥:穿孔9例(45%)、食管糜爛6例(30%)、食管潰瘍4例(20%)、食管粘膜出血1例(5%)。其中2例因不能用內鏡取出而行外科行手術治療。4.通過logistic回歸分析得出上消化道異物所致并發(fā)癥的危險因素為:異物存在的時間"g12h(OR=9.04,95%CI:2.91-28.04;P=0.000)及邊緣銳利(OR=7.95,95%CI:2.09-30.21;P=0.002)。結論:1.棗核是本地區(qū)最常見的異物類型;而食管為異物最常見的嵌頓部位,尤以食管上段為甚;2.異物存在的時間"g12h及其邊緣銳利是上消化道異物導致并發(fā)癥的危險因素,應綜合評估后選擇合適的治療方案。
[Abstract]:Objective: to summarize the clinical features of upper gastrointestinal foreign bodies and analyze the risk factors of complications. Methods: the clinical data of four hospitals (General Hospital, Xixia Branch, Ningnan Branch, Emergency Center) of Ningxia Hui Autonomous region people's Hospital from January 2015 to December 2016 due to upper gastrointestinal tract foreign body were retrospectively analyzed. And summarize its clinical characteristics: 1. Age, sex, symptoms, causes of ingestion of foreign bodies, coexistence of digestive tract diseases; 2. The type, size, quantity, position, edge of the foreign body are sharp; 3. Time of existence of foreign body, time of taking foreign body, instruments used, occurrence of complications, mortality rate, number of cases undergoing surgery. The risk factors of complications were studied by logistic regression analysis. The result is 1: 1. The types of foreign bodies in upper digestive tract were as follows: jujube seed (47.5%), animal bone (26.0%), food mass (15.5%), pill packing (2.5%), coin (2.5%), denture (2.0%). Button (1.5%), plastic (1.0%), metal strip (1.0%), wire (0.5%). Foreign body size 32.98 鹵11.35 (6-80) mm; The foreign bodies were found in the upper esophagus (77.5%), the lower esophagus (9.0%), the middle esophagus (7.5%) and the gastric cavity (6.0%). 3.200 cases of upper gastrointestinal foreign bodies were removed by endoscopy. Severe complications occurred in 20 cases (10.0%): perforation in 9 cases (45%), esophageal erosion in 6 cases (30%), esophageal ulcer in 4 cases (20%), and esophageal mucosal hemorrhage in 1 case (5%). Two of them were treated surgically because they could not be removed by endoscope. 4. By logistic regression analysis, the risk factors of complications caused by foreign bodies in upper digestive tract are as follows: time of existence of foreign bodies "g 12h (OR=9.04,95%CI:2.91-28.04;P=0.000) and edge sharpness (OR=7.95,95%CI:2.09-30.21;)." P0. 002). Conclusion: 1. Jujube nucleus is the most common type of foreign body in this area, and esophagus is the most common inlay of foreign body, especially in the upper part of esophagus. The time of existence of foreign bodies "g12h and sharp edge are the risk factors of complications caused by foreign bodies in upper digestive tract. The appropriate treatment should be selected after comprehensive evaluation."
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R57

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