老年早期食管癌内镜下黏膜剥离术后狭窄高危因素分析  

Risk factors of stricture after endoscopic submucosal dissection in elderly patients with early esophageal cancer

作　　者：吕尚泽 段睿 LV Shang-ze;DUAN Rui(Department of Gastroenterology,Jingzhou to Yangtze University Hospital,434020 Jingzhou,Hubei,China;Department of Gastroenterology,the first people’s Hospital of Jingzhou,434100 Jingzhou,Hubei,China)

机构地区：[1]长江大学附属荆州医院消化内科,湖北荆州434020 [2]荆州市第一人民医院消化内科,湖北荆州434100

出　　处：《临床消化病杂志》2025年第1期12-15,共4页Chinese Journal of Clinical Gastroenterology

基　　金：湖北省卫生健康委2021~2022年度面上项目(No:73,项目名:RACGAP1通过PI3K/AKT信号通路促进肝细胞癌增殖和转移)。

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]选择行内镜下黏膜剥离术治疗的老年食管早癌患者239例,观察内镜下黏膜剥离术后狭窄发生情况。对患者性别、糖尿病史、高血压病史、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例患者中术后狭窄37例,发生率为15.48%。经单因素分析表明,术后狭窄组与术后无狭窄组性别、糖尿病史、高血压病史、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);术后狭窄组与术后无狭窄组病变直径、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>5cm、病变深度m3+sm、高PLR和高NLR为影响术后狭窄高危因素。[结论]食管早癌内镜下黏膜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 of esophageal stricture after endoscopic submucosal dissection..[Methods]A total of 239elderly patients with early esophageal cancer who underwent endoscopic submucosal dissection were selected to observe the occurrence of stricture after endoscopic submucosal dissection.Multivariate logistic regression analysis was used to analyze the relationship between gender,diabetes history,hypertension history,smoking history,drinking history,focus location,lesion diameter,lesion shape,infiltration depth,PLR,NLR and postoperative stricture.[Results]Total 37cases of postoperative stricture occurred in the 239cases of early esophageal cancer treated by endoscopic submucosal dissection,the incidence was 15.48%.Single factor analysis showed that there was no significant difference in gender,diabetes history,hypertension history,smoking history,drinking history,lesion location and infiltration depth between the postoperative stricture group and the non stricture group(P>0.05);there was significant difference in lesion diameter,lesion depth,PLR and NLR between the postoperative stricture group and the non stricture group(P<0.05).Multivariate logistic regression analysis showed that the diameter of lesions>5cm,depth of lesions m3+SM,high PLR and high NLR were the high risk factors of postoperative stricture.[Conclusion]The incidence of stricture after endoscopic resection of early esophageal cancer is high,among which the diameter of lesion>5cm,the depth of lesion m3+SM,high PLR and high NLR are the high risk factors.

关 键 词：老年食管早癌 内镜下黏膜剥离术 术后狭窄 高危因素 

分 类 号：R735.1[医药卫生—肿瘤]