不同年龄及部位消化系统疾病内镜黏膜下剥离术后并发症的发生风险比较

Comparison of postoperative complications in patients with ESD at different ages and sites

摘要:

目的 比较不同年龄及病变部位消化系统疾病内镜黏膜下剥离术（ESD）后并发症发生风险。方法 对该院2019年6月－2021年6月120例ESD患者进行研究，根据患者手术时年龄分为老年组（≥ 60岁，52例）和非老年组（ < 60岁，68例）。对比两组患者性别和病变部位（包括食管、胃、十二指肠、结肠和直肠）等信息。统计两组患者术后并发症发生情况（发热、术后穿孔、狭窄和出血），以及两组患者不同病变部位并发症发生情况。比较不同病变部位总的并发症发生情况。将有差异的因素纳入Logistic模型，行量化赋值，明确ESD术后发生并发症的危险因素。结果 两组患者性别和病变部位比较，差异无统计学意义（P > 0.05）。老年组术后发热和狭窄发生率明显高于非老年组（P < 0.05），术后穿孔和出血发生率比较，差异无统计学意义（P > 0.05）。两组患者食管、胃、十二指肠、结肠和直肠的并发症发生情况比较，差异均无统计意义（P > 0.05）。不同病变部位并发症总发生率比较，差异有统计学意义（P < 0.05）。经多因素Logistic回归分析证实，老年和食管病变是ESD术后发生并发症的危险因素（P < 0.05）。结论 老年和病变部位在食管的消化系统疾病ESD术后并发症发生风险较高。在对老年和有食管病变的消化系统疾病患者进行治疗时，需密切观察患者情况，并及时进行干预，以降低术后并发症的发生率。

Abstract:

Objective To compare the risk of postoperative complications in patients with endoscopic submucosal dissection (ESD) at different ages and lesion sites.Methods 120 patients with ESD from June 2019 to June 2021 were studied. According to their age at the time of operation, they were divided into elderly group (≥ 60 years old, 52 cases) and non elderly group ( < 60 years old, 68 cases). The information of gender and lesion location (including esophagus, stomach, duodenum, colon and rectum) were compared between the two groups. The incidence of postoperative complications (fever, postoperative perforation, stenosis and bleeding) in the two groups were counted, the complications of different lesion sites in the two groups were counted. The total complications of different lesion sites were counted. The different single factor information was included in the Logistic model, and the quantitative evaluation was performed to clarify the risk factors of complications after ESD.Results There was no significant difference in gender and lesion location between the two groups (P > 0.05). The incidence of postoperative fever and stenosis in the elderly group was significantly higher than that in the non elderly group (P < 0.05), there was no significant difference in the incidence of perforation and bleeding between the two groups (P > 0.05). There was no significant difference in the incidence of complications of esophagus, stomach, duodenum, colon and rectum between the two groups (P > 0.05). There was a significant difference in the total incidence of complications at different lesion sites (P < 0.05). Multivariate Logistic regression analysis confirmed that old age and esophageal lesions were risk factors for postoperative complications in ESD, both with P < 0.05.Conclusion The risk of ESD complications of digestive diseases in the esophagus is high. Therefore, when treating elderly patients with digestive diseases, patients need to be closely observed and conduct timely intervention to reduce the incidence of postoperative complications.