湖北三峡地区消化道异物的临床特征及危险因素  

Clinical characteristics and risk factors of gastrointestinal foreign bodies in the Three Gorges area of Hubei Province

作　　者：魏道慧 刘伟[1] WEI Daohui;LIU Wei(Department of Gastroenterology,Yichang Central People’s Hospital,Institute of Digestive Diseases,Three Gorges University,Yichang Hubei 443002,China)

机构地区：[1]宜昌市中心人民医院消化内科,三峡大学消化疾病研究所,湖北宜昌443002

出　　处：《临床与病理杂志》2024年第6期835-844,共10页Journal of Clinical and Pathological Research

基　　金：宜昌市医疗卫生研究项目(A24-2-008)。

摘　　要：目的:消化道异物是指非自身所固有的物质嵌顿于消化道,是临床常见急危重症之一。本研究探讨湖北三峡地区消化道异物的临床特征及其危险因素。方法:收集2019年1月至2022年12月587例因消化道异物嵌顿就诊于宜昌市中心人民医院住院患者的临床资料,对其临床特征及危险因素进行分析。结果:本研究共收集621例消化道异物住院患者,根据排除标准剔除34例,进入临床分析的患者共587例。异物类型以鱼刺和兽骨等尖锐异物最常见,分别占比53.8%和18.2%。不同年龄段儿童的异物类型以硬币、纽扣电池为主,中青年患者以鱼刺、兽骨为主,而老年患者以鱼刺、食团为主。异物滞留部位(总数为491例)以食管上段异物最多(380例,77.4%),食管中下段(67例,13.7%)和胃(32例,6.5%)次之,下消化道较罕见(4例,0.8%)。内镜取出为消化道异物首选的诊疗方法,内镜取出率为96.1%。出血为消化道异物常见并发症(183例,37.3%),穿孔为最严重并发症(27例,4.6%)。尖锐异物和异物滞留时间≥24 h是并发症的危险因素。结论:鱼刺、兽骨等尖锐异物为消化道常见异物类型。儿童常见异物类型为硬币、纽扣电池,中青年患者以鱼刺、兽骨为主,老年患者以鱼刺、食团为主。食管上段为消化道异物的常见滞留部位,内镜取出为消化道异物首选的诊疗方法,辅以静脉麻醉可以提高异物的取出率。出血是消化道异物的常见并发症,尖锐异物和异物滞留时间≥24 h患者的并发症发生率高。Objective:Gastrointestinal foreign bodies refer to non-native substances lodged in the digestive tract,and they are one of the common clinical emergencies.This study aims to explore the clinical characteristics and risk factors of gastrointestinal foreign bodies in the Three Gorges area of Hubei Province.Methods:A retrospective analysis was conducted on the clinical data of 587 inpatients who were diagnosed with gastrointestinal foreign bodies at Yichang Central People’s Hospital from January 2019 to December 2022.The study analyzed their clinical characteristics and associated risk factors.Results:A total of 621 cases of gastrointestinal foreign body inpatients were collected for this study.After applying inclusion and exclusion criteria,34 cases were excluded,leaving 587 cases for clinical analysis.The types of foreign bodies identified included sharp objects such as fish bones and animal bones,which were the most common,accounting for 53.8%and 18.2%of cases,respectively.The types of foreign bodies varied by age group:children mostly ingested coins and button batteries,middle-aged patients commonly ingested fish bones and animal bones,while elderly patients frequently ingested fish bones and food boluses.The most common site for foreign body retention(with a mumber of 491 cases)was the upper esophagus(380 cases,77.4%),followed by the mid-lower esophagus(67 cases,13.7%),and the stomach(32 cases,6.5%);lower gastrointestinal tract cases were rare(4 cases,0.8%).Endoscopic removal was the preferred method for treating gastrointestinal foreign bodies,with a success rate of 96.1%.Bleeding was the most common complication(183 cases,37.3%),while perforation was the most severe(27 cases,4.6%).Sharp foreign bodies and retention time≥24 hours were identified as risk factors for complications.Conclusion:Sharp objects such as fish bones and animal bones are the most common types of gastrointestinal foreign bodies.Coins and button batteries are frequently found in children,fish bones and animal bones are common in middle-

关 键 词：消化道异物 内镜 并发症 危险因素 

分 类 号：R57[医药卫生—消化系统]