摘要
目的探讨内镜黏膜下剥离术(ESD)治疗食管早癌患者术后并发食管狭窄的危险因素。方法选取我院ESD治疗197例食管早癌患者(2014年1月至2016年8月)进行回顾性分析,其中26例患者并发术后食管狭窄(狭窄组)、171例患者术后未并发食管狭窄(非狭窄组),对比两组患者的各项基础资料、临床资料,并采用非条件Logistic回归分析法探讨ESD术后并发食管狭窄的危险因素。结果狭窄组和非狭窄组患者的年龄、性别、病灶位置比较,差异均无统计学意义(P>0.05);狭窄组患者的鳞状细胞癌占比73.08%、病灶纵向长径(44.8±13.0)mm、病变环周直径(38.0±11.0)mm、术后创面>3/4食管周径患者占比57.69%、组织浸润深度达到m3+sm1患者占比76.92%均显著的高于非狭窄组患者的鳞状细胞癌占比52.05%、病灶纵向长径(31.6±10.7)mm、病变环周直径(27.3±9.6)mm、术后创面>3/4食管周径患者占比30.41%、组织浸润深度达到m3+sm1患者占比29.82%,差异有统计学意义(P<0.05);病灶纵向长径过长、病变环周直径过大、术后创面>3/4食管周径、组织浸润深度(m3+sm1)是食管早癌患者ESD术后并发食管狭窄的独立危险因素(OR值分别为1.982、1.715、1.552、2.281)。讨论食管早癌患者ESD术后并发食管狭窄的独立危险因素有病灶纵向长径过长、病变环周直径过大、术后创面>3/4食管周径、组织浸润深度过深。
Objective To investigate the risk factors of postoperative restenosis in patients with early esophageal cancer treated by endoscopic submucosal dissection（ESD）.Methods 197 cases of patients with early esophageal cancer treated by ESD during January 2014 to August 2016 in our hospital were retrospectively analyzed,among which,26 patients supervened postoperative restenosis and were therefore attributed to stenosis group,while 171 patients did not supervene esophageal stenosis and were attributed to non-stenosis group.Both basic information and clinical data of patients in the two groups were compared,and unconditional Logistic regression analysis was adopted to investigate the risk factors of post-ESD esophageal stenosis. Results There was no statistically significant difference between stenosis group and non-stenosis group in patient age,gender and position of lesions（P〈0. 05）.In stenosis group,squamous cell carcinoma accounted for 73. 08%,the longitudinal diameter of lesions was（44. 8±13. 0） mm,the circumferential diameter of lesions was（38. 0±11. 0） mm,patients with postoperative wound wider than 3/4 esophageal circumference accounted for 57. 69% and patients with tissue infiltration depth reaching m3＋sm1 accounted for 76. 92%.Those were all significantly higher than non-stenosis group,as in non-stenosis group,squamous cell carcinoma patients accounted for52. 05%,the longitudinal diameter of lesions was（31. 6± 10. 7） mm,the circumferential diameter of lesions was（27. 3 ± 9. 6） mm,patients with postoperative wound wider than 3/4 esophageal circumference accounted for 30. 41% and patients with tissue infiltration depth reaching m3＋sm1 accounted for 29. 82%,the difference being statistically significant（P〈0. 05）.Long longitudinal diameter as well as circumferential diameter of lesions,postoperative wound wider than 3/4 esophageal circumference and tissue infiltration depth reaching m3＋sm1 were independent risk factors of post-ESD esophageal stenosis in patients with early
出处
《四川医学》
CAS
2017年第10期1208-1211,共4页
Sichuan Medical Journal
关键词
内镜黏膜下剥离术
食管早癌
食管狭窄
危险因素
endoscopic submucosal dissection
early esophageal cancer
esophageal stenosis
risk factors
