Analyzing the risk factors of upper gastrointestinal tract injury caused by foreign bodies
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摘要: 目的 探讨儿童上消化道异物的种类、异物所处消化道位置及异物并发的消化道损伤，对儿童发生上消化道异物造成消化道损伤的相关危险因素进行分析，为上消化道异物的诊断及干预提供进一步的资料及依据。方法 选择安徽省儿童医院2018年6月-2021年6月期间因上消化道异物就诊且完善了无痛电子胃镜(胃镜型号为OLYMPUS EG-270WR5)检查的313例患儿作为研究对象。对上消化道异物患儿的年龄分布、异物类型、胃镜检查情况、发生异物月份分布等相关危险因素进行单因素和多因素分析。结果 明确诊断消化道异物的313例患儿完善无痛胃镜检查，异物具有腐蚀性、异物形态尖锐、异物位于食管处、异物位于十二指肠处是发生消化道损伤的相关危险因素(OR=11.208、4.316、3.6366、6.9974，均P< 0.05)。结论 通过对上消化道异物引起消化道损伤的危险因素进行分析，在患儿就诊时选取合理治疗方式，从而降低消化道损伤的可能性。Abstract: Objective To investigate the type and location of foreign bodies in upper gastrointestinal tracts, as well as gastrointestinal injury caused by foreign bodies in children. To analyze the risk factors of gastrointestinal tract injury caused by foreign bodies in children, providing information and basis for further diagnosis and intervention of foreign bodies in upper gastrointestinal tracts.Methods A total of 313 cases of children, from June 2018 to June 2021 in a children's hospital of Anhui Province, with upper gastrointestinal foreign bodies diagnosed by painless gastrofiberscopy(OLYMPUS EG-270WR5), were selected as the study subjects.Results A total of 313 cases of children with gastrointestinal foreign bodies were diagnosed by painless gastrofiberscopy. Corrosive foreign bodies, sharp shaped foreign bodies, foreign bodies located in the esophagus and duodenum were related factors of digestive tract injuries(ORvalues were 11.208, 4.316, 3.6366, 6.9974, allP< 0.05).Conclusion By analyzing the risk factors of upper gastrointestinal tract injury caused by foreign bodies, we can select reasonable treatments for children to reduce possible digestive tract injuries.
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Key words:
- upper gastrointestinal foreign bodies /
- children /
- digestivetract injury
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表 1 上消化道并发症危险因素的单因素分析
例(%) 因素 无并发症(183例) 有并发症(130例) χ2 P 性别 1.298 0.255 男 120(65.57) 94(72.31) 女 63(34.43) 36(27.69) 胃内 0.163 0.686 否 103(56.28) 77(59.23) 是 80(43.72) 53(40.77) 十二指肠上部与降部、降部与水平部 22.037 < 0.001 否 172(93.99) 97(74.62) 是 11(6.01) 33(25.38) 食管狭窄处 3.901 0.048 否 147(80.33) 91(70.00) 是 36(19.67) 39(30.00) 先天性消化道疾病 0.085 0.77 否 173(94.54) 121(93.08) 是 10(5.46) 9(6.92) 异物具有腐蚀性 17.977 < 0.001 否 172(93.99) 100(76.92) 是 11(6.01) 30(23.08) 异物形态尖锐 21.709 < 0.001 否 159(86.89) 83(63.85) 是 24(13.11) 47(36.15) 年龄/岁 fisher 0.051 < 2 51(27.90) 54(41.50) 2~ < 4 63(34.40) 39(30.00) 4~ < 6 37(20.20) 19(14.60) 6~ < 8 16(8.70) 10(7.70) 8~ < 10 9(4.90) 2(1.50) 10~ < 12 2(1.10) 5(3.80) 12~14 5(2.70) 1(0.80) 
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表 2 上消化道异物并发症相关危险因素多因素分析
变量 β SE Z P OR 95%CI 异物具有腐蚀性 2.455 0.412 5.956 < 0.001 11.650 5.193~26.137 异物形态尖锐 1.477 0.327 4.515 < 0.001 4.381 2.307~8.319 于十二指肠上部与降部、降部与水平部 1.955 0.418 4.674 < 0.001 7.063 3.111~16.032 食管狭窄处 1.289 0.314 4.099 < 0.001 3.629 1.960~6.721
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