食管异物需手术干预的危险因素分析

目的探讨食管异物病例需外科手术干预的危险因素。方法将1962年1月至2011年1月西安唐都医院胸外科收治并进行手术干预的43例食管异物病例作为研究对象;按性别和年龄（相差不超过5岁）进行匹配,选取同期经保守治疗的43例食管异物病例作为对照。收集资料包括异物类型、异物存留时间、异物存留部位、是否伴有并发症。采用单因素及多因素条件logistic回归分析来明确食管异物病例需手术干预的危险因素。结果单因素分析显示,异物类型、异物存留时间、异物存留部位、是否伴有并发症是食管异物需手术干预的危险因素（均P〈0．05）。多因素分析显示．异物类型（锐性异物）是食管异物需手术干预的独立危险因素（P=0．043;OR=29．228,95％CI：1．114～766．686）。结论锐性食管异物应引起临床医师的高度重视,可结合异物存留时间和存留部位及是否伴有并发症等因素决定是否进行手术治疗。

Rick factors of surgical interventions in patients with esophageal foreign bodies

Objective To investigate the risk factors of surgical interventions in patients with esophageal foreign bodies (EFBs). Methods Forty-three cases with EFBs underwent surgical interventions from January 1962 to January 2011 in Department of Thoracic Surgery at the Tangdu Hospital were enrolled in the study group. Forty three cases with EFBs who received non-surgical treatment in the same hospital and during the same period matched by gender and age (the age difference between the paired patients was 5 years or less) were selected as the control group. Clinical data including type of EFBs, duration of impaction, location of EFBs, complications associated with EFBs were collected. Univariate and multivariate conditional logistic analysis were used for risk factors analysis. Results Univariate conditional logistic analysis showed that type of EFBs, duration of impaction, location of EFBs, and complications associated with EFBs were risk factors of surgical interventions in patients with EFBs (P＜0.05). Further multivariate conditional logistic analysis showed that type of EFBs (sharp EFBs) was the independent factor of surgical interventions in patients with EFBs(P=0.043;OR=29.228,95％ CI: 1.114-766.686). Conclusions Physician should pay more attention to patients with sharp EFBs. Whether the patients need surgical interventions or not should base on factors including duration of impaction, location of EFBs, and complications associated with EFBs.