摘要
目的观察食管癌(EC)患者术后难治性狭窄发生情况,探讨患者发生难治性狭窄的高危因素。方法选择焦作市人民医院2017年7月至2021年7月行内镜黏膜下剥离术(ESD)治疗的135例EC患者。统计EC患者术后3个月时难治性狭窄发生情况并分组,设计调查表,记录患者一般资料,探析EC患者术后发生难治性狭窄的高危因素。结果术后随访3个月,135例EC患者中,发生难治性狭窄40例,占比为29.63%。单因素分析显示,狭窄组合并糖尿病、浸润程度为M3和SM1、术中固有肌层损伤占比高于非狭窄组,病灶纵向长径大于非狭窄组,差异有统计学意义(P<0.05)。两组合并高血压、肿瘤类型、肿瘤分期等资料比较,差异无统计学意义(P>0.05)。多因素分析显示,合并糖尿病、病灶纵向长径大、肿瘤浸润程度为M3和SM1、术中固有肌层损伤是EC患者术后发生难治性狭窄的高危因素(OR>1,P<0.05)。结论EC患者术后发生难治性狭窄的高危因素为合并糖尿病、病灶纵向长径大、肿瘤浸润程度为M3和SM1、术中固有肌层损伤。
Objective To observe the occurrence of postoperative refractory stricture in patients with esophageal cancer(EC)and to explore the high-risk factors of refractory stricture in patients.Methods A total of 135 patients with EC who underwent endoscopic submucosal dissection(ESD)in Jiaozuo People’s Hospital from July 2017 to July 2021 were selected.The occurrence of refractory stricture in patients with EC at 3 months after operation was counted and divided into groups.A questionnaire was designed,the general information of patients was recorded,and the high-risk factors of postoperative refractory stricture in patients with EC were explored.Results After 3 months of follow-up,40 of 135 patients with EC after operation developed refractory stenosis,accounting for 29.63%.Univariate analysis showed that the proportions of complicated with diabetes mellitus,M3 and SM1 degree of infiltration,intraoperative intrinsic muscularis injury in the stenosis group were higher than those in the non stenosis group,and the longitudinal length and diameter of the lesion was larger than that in the non stenosis group,and the difference was statistically significant(P<0.05).There were no statistical significant differences in terms of hypertension,tumor type and tumor stage between the two groups(P>0.05).Multivariate analysis showed that diabetes mellitus,large longitudinal length and diameter of the lesion,M3 and SM1 tumor infiltration degree and intraoperative intrinsic muscularis injury were high-risk factors for postoperative refractory stricture in patients with EC(OR>1,P<0.05).Conclusion The high-risk factors of postoperative refractory stricture in patients with EC are complicated with diabetes mellitus,large longitudinal diameter of lesion,M3 and SM1 tumor infiltration degree,and intraoperative muscularis propria injury.
作者
杨艳洁
孔坤坤
罗媛媛
YANG Yanjie;KONG Kunkun;LUO Yuanyuan(Department of Oncology,Jiaozuo People’s Hospital,Jiaozuo 454150,China)
出处
《河南医学研究》
CAS
2022年第24期4484-4487,共4页
Henan Medical Research
关键词
食管癌
内镜黏膜下剥离术
难治性狭窄
esophageal cancer
endoscopic submucosal dissection
refractory stenosis
