小儿食管异物并发症的相关性研究  

Influencing factors for complications of esophageal foreign bodies in children ）

作　　者：杨洪彬[1] 方莹[1] 任晓侠[1] 张含花[1] 

机构地区：[1]西安市儿童医院消化内科,710003

出　　处：《中华消化内镜杂志》2017年第2期83-87,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨小儿食管异物嵌顿后易发并发症的相关因素。方法2012年1月至2015年6月，在西安市儿童医院行内镜下食管异物取出术的150例患儿纳入回顾性分析。相关临床指标（患儿性别、年龄，异物嵌顿部位、嵌顿时间、大小、尖锐程度、性质，并发症严重程度等）行统计学分析。结果Spearman秩相关分析发现患儿年龄与食管异物并发症的发生呈明显负相关关系（r=-0．187，P=0．022），异物嵌顿时间（r=0．456，P〈0．001）、尖锐程度（r=0．384，P〈0．001）及性质（r=0．234，P=0．004）与并发症的发生呈明显正相关。多分类有序反应变量的非条件Logistic回归分析发现，嵌顿时间≥8h的并发症发生风险是〈8h的9．507倍（95％CI：2．982～30．309），有钝角／尖锐异物的并发症发生风险是光滑的142．751倍（95％C1：13．736—1483．562）。结论小儿食管异物并发症的发生及严重程度与患儿的年龄、异物嵌顿时间、异物尖锐程度密切相关。对于年龄小于1岁的儿童，异物嵌顿时间大于8h或有钝角／尖锐的更应受到重视，尽早诊断及积极治疗至关重要。Objective To investigate the influencing factors related to the complications of esophageal foreign body in children. Methods Data of 150 children with esophageal foreign bodies admitted to Xi＇an Children＇s Hospital from January 2012 to June 2015 were included in the retrospective analysis. Related clinical variables （gender, age, location, time, size, sharpness, quality, and severity of complications） were statistically analyzed. Results Spearman correlation analysis showed that the age of children was negatively correlated with esophageal foreign body complications （r =-0. 187, P = 0. 022） , incarceration time （r = 0. 456, P〈0. 001 ）, sharpness （ r = 0. 384, P〈0. 001 ） and quality （ r = 0. 234, P = 0. 004） was positively correlated with the incidence of complications. Non-conditional Logistic regression analysis for polytomous ordinal response showed that incarceration longer than 8 h yielded complication risks 9. 507 times as much as that less than 8 h （95%CI：2. 982-30. 309）. Obtuse or sharp foreign body yielded risk 142. 751 times as smooth foreign body did （95%CI： 13. 736-1 483. 562）. Conclusion Incidence and severity of complications of esophageal foreign body in children are closely related to the age of the children, incarceration time and the degree of sharpness. For patients of less than 1 year old, incarceration for more than 8 hours, with an obtuse or sharp foreign body, early diagnosis and treatment is essential.

关 键 词：儿童 食管异物 并发症 相关性 

分 类 号：R768.32[医药卫生—耳鼻咽喉科]