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]选择行内镜黏膜下剥离术治疗的老年食管早癌患者239例,观察内镜黏膜下剥离术后狭窄发生情况.对患者性别、年龄、病变分型、操作时间、糖尿病史、高血压史、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例中术后狭窄37例(狭窄组),发生率为15.48％;202例属无狭窄组.经单因素分析表明,狭窄组与无狭窄组性别、年龄、病变分型、操作时间、糖尿病史、高血压史、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);狭窄组与无狭窄组病变直径、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＞5 cm、病变深度m3+sm、高PLR和高NLR为影响术后狭窄高危因素.[结论]食管早癌内镜黏膜下剥离术后狭窄发生率较高,其中病变直径＞5 cm、病变深度m3+sm、高PLR和高NLR为其高危因素.
Abstract
[Objective]To analyze the high-risk factors for strictures after endoscopic submucosal dissec-tion for esophageal early carcinoma.[Methods]A total of 239 elderly patients with early esophageal cancer treated by endoscopic submucosal dissection were selected.The occurrence of strictures after endoscopic submucosal dissection was observed.The associations between patient sex,age,diabetes mellitus,hyperten-sion,smoking,drinking,lesion location,lesion diameter,lesion morphology,depth of invasion,platelet lym-phocyte ratio(PLR),and neutrophil ratio(NLR)and postoperative strictures were evaluated using multiva-riate logistic regression.[Results]The totals of 239 elderly patients with early esophageal cancer who un-derwent endoscopic submucosal dissection had 37 postoperative strictures,which occurred in 15.48％.By univariate analysis,there was no significant difference in sex,age,diabetes mellitus history,hypertension history,smoking history,drinking history,lesion location and infiltration depth between patients with and without postoperative strictures(P＞0.05).The differences in lesion diameter,lesion depth,PLR,and NLR between the group with postoperative strictures and the group without postoperative stenosis were statistically significant(P＜0.05).After multivariate logistic regression analysis,lesion diameter＞5 cm,lesion depth m3+SM,high PLR and high NLR were identified as high risk factors for postoperative ste-nosis.[Conclusion]The stricture rate was higher after endoscopic submucosal dissection for early esophage-al cancer,in which lesion diameter＞5 cm,lesion depth m3+SM,high PLR and high NLR.
维普
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