杨丛 梁丁保 徐林生 白芸

【摘要】目的：探讨胃镜下消化道异物取出及相关危险因素。方法：回顾性分析2016年6月～2018年6月我院收治的188例消化道异物患者临床病例资料，将其中168例电子胃镜取出者作为研究组，20例未取出者作为对照组，并分析影响胃镜下消化道异物取出的危险因素。结果：经单因素分析发现，研究组异物边缘锐利、异物位于胃管及以下、异物大小≥3.0cm和异物存在时间≥12h等比例显著高于对照组（P<0.05），而研究组患者年龄、性别、合并疾病比例等与对照组比较差异不显著（P>0.05）；经多因素Logistic分析发现，异物边缘锐利、异物位于胃腔以下、异物大小≥3.0cm和异物存在时间≥12h是影响胃镜下消化道异物取出的危险因素。结论：胃镜下消化道异物取出成功率与异物形状、异物部位、异物大小和异物存在时间具有一定相关性。

【关键词】胃镜下；消化道异物取出；相关危险因素；分析

[Abstract] Objective：To explore the removal of foreign bodies in the digestive tract under gastroscopy and related risk factors. Methods：Retrospective analysis of 188 patients with digestive tract foreign body admitted to our hospital from June 2016 to June 2018. Among them， 168 patients with electronic gastroscope were selected as the study group， and 20 patients were not taken out as the control group. Analysis of the risk factors affecting the removal of foreign bodies in the digestive tract under endoscopy. Results： Univariate analysis showed that the margin of foreign body in the study group was sharp， the foreign body was located in the stomach tube and below， the size of foreign body was ≥3.0cm and the time of foreign body was ≥12h， which was significantly higher than that of the control group （P<0.05）. The proportion of combined diseases was not significantly different from that of the control group （P>0.05）. Multivariate logistic analysis showed that the sharp edges of foreign bodies， foreign bodies located below the gastric cavity， foreign body size ≥3.0cm and foreign body existence time ≥12h were affected by gastroscope digestion. Risk factors for the removal of foreign bodies. Conclusion：The success rate of removal of foreign bodies in the digestive tract under gastroscopy has a certain correlation with the shape of foreign bodies， the location of foreign bodies， the size of foreign bodies and the time of foreign body.

[Key words] Gastroscope； removal of foreign bodies in the digestive tract； related risk factors； analysis

【中圖分类号】R445

【文献标识码】B

【文章编号】2095-6851（2018）10-141-01

消化道异物是指患者无意识吞入或者随着食物、药物咽下而停留在消化道内无法被消化的物体，常见的消化道异物包括鱼刺、鸡骨、钉子和钱币，这类异物即不能被消化，又无法通过幽门，多停留在胃部，或者嵌顿在十二指肠[1]。大量文献报道，异物嵌顿于颈部狭窄处、上胸段或下食管，而一旦无法及时取出异物，对消化道粘膜将造成极大影响，并提高纵膈炎和胸膜炎的发生率，部分患者会因异物刺破食管壁主动脉而引发大出血，进而危及患者身心健康和生命安全[2]。

1 资料和方法

1.1 一般资料

选取2016年6月～2018年6月我院收治的188例消化道异物患者进行分析，所有患者有异物误吞史，多数患者有咽部不适、恶心呕吐和疼痛，经消化道内镜检查确诊为消化道异物，诊疗记录资料齐全且完善。……