老年食管早癌内镜黏膜下剥离术后狭窄的高危因素分析  

Analysis of high risk factors of strictures after endoscopic submucosal dissection of early esophageal cancer in the elderly

作　　者：张顺利 赵海明 赵成茂 ZHANG Shun-li;ZHAO Hai-ming;ZHAO Cheng-mao(Department of Gastroenterology,Qinghai Red Cross Hospital,810000Xining,Qinghai,China;Department of Gastroenterology,the Fifth People's Hospital of Qinghai Province&Qinghai Tumor Hospital,811000Xining,Qinghai China)

机构地区：[1]青海红十字医院消化内科,青海西宁810000 [2]青海省第五人民医院/青海省肿瘤医院消化专科,青海西宁811000

出　　处：《临床消化病杂志》2024年第1期27-30,共4页Chinese Journal of Clinical Gastroenterology

基　　金：青海省医药卫生科技项目(No:2016QW073)。

摘　　要：[目的]分析食管早癌内镜黏膜下剥离术后狭窄的高危因素。[方法]选择行内镜黏膜下剥离术治疗的老年食管早癌患者239例,观察内镜黏膜下剥离术后狭窄发生情况。对患者性别、年龄、病变分型、操作时间、糖尿病史、高血压史、吸烟史、饮酒史、病灶部位、病变直径、病变形态、浸润深度、血小板淋巴细胞比值(PLR)、中性淋巴细胞比值(NLR)与术后狭窄的关系采用多因素Logistic回归分析。[结果]239例中术后狭窄37例(狭窄组),发生率为15.48%;202例属无狭窄组。经单因素分析表明,狭窄组与无狭窄组性别、年龄、病变分型、操作时间、糖尿病史、高血压史、吸烟史、饮酒史、病灶部位和浸润深度比较差异无统计学意义(P>0.05);狭窄组与无狭窄组病变直径、病变深度、PLR和NLR比较差异有统计学意义(P<0.05)。经多因素Logistic回归分析显示,病变直径>5 cm、病变深度m3+sm、高PLR和高NLR为影响术后狭窄高危因素。[结论]食管早癌内镜黏膜下剥离术后狭窄发生率较高,其中病变直径>5cm、病变深度m3+sm、高PLR和高NLR为其高危因素。[Objective]To analyze the high-risk factors for strictures after endoscopic submucosal dissection for esophageal early carcinoma.[Methods]A total of 239elderly patients with early esophageal cancer treated by endoscopic submucosal dissection were selected.The occurrence of strictures after endoscopic submucosal dissection was observed.The associations between patient sex,age,diabetes mellitus,hypertension,smoking,drinking,lesion location,lesion diameter,lesion morphology,depth of invasion,platelet lymphocyte ratio(PLR),and neutrophil ratio(NLR)and postoperative strictures were evaluated using multivariate logistic regression.[Results]The totals of 239elderly patients with early esophageal cancer who underwent endoscopic submucosal dissection had 37postoperative strictures,which occurred in 15.48%.By univariate analysis,there was no significant difference in sex,age,diabetes mellitus history,hypertension history,smoking history,drinking history,lesion location and infiltration depth between patients with and without postoperative strictures(P>0.05).The differences in lesion diameter,lesion depth,PLR,and NLR between the group with postoperative strictures and the group without postoperative stenosis were statistically significant(P<0.05).After multivariate logistic regression analysis,lesion diameter>5cm,lesion depth m3+SM,high PLR and high NLR were identified as high risk factors for postoperative stenosis.[Conclusion]The stricture rate was higher after endoscopic submucosal dissection for early esophageal cancer,in which lesion diameter>5cm,lesion depth m3+SM,high PLR and high NLR.

关 键 词：老年食管早癌 内镜黏膜下剥离术 术后狭窄 高危因素 

分 类 号：R735.1[医药卫生—肿瘤]