Objective: To study the complications of upper gastrointestinal foreign body in children and related risk factors.
Methods: Clinical data were collected from 772 children with upper gastrointestinal foreign bodies who were treated at the outpatient service or were hospitalized from January 2014 to December 2018. A multivariate logistic regression analysis was used to investigate the risk factors for the development of complications in children with upper gastrointestinal foreign bodies.
Resilts: The upper gastrointestinal foreign bodies were taken out by electronic endoscopy for the 772 children. There were 414 boys and 358 girls, with a median age of 2.8 years. Children under 3 years old accounted for 59.5%. The foreign bodies were mainly observed in the esophagus (57.5%) and the stomach (28.9%), with a retention time of ≤24 hours in 465 children (60.2%) and >24 hours in 307 children (39.8%). The types of upper gastrointestinal foreign bodies mainly included round metal foreign bodies (37.2%), long foreign bodies (24.7%), sharp foreign bodies (16.2%), batteries (14.4%), corrosive substances (4.8%), and magnets (2.7%). As for the severity of complications, 47.7% (368 children) had mild complications, 12.7% (98 children) had serious complications, and 39.6% (306 children) had no complications. The logistic regression analysis showed that an age of <3 years, underlying diseases, location of foreign body, type of foreign body, and a retention time of >24 hours were risk factors for the development of complications in these children (OR=2.141, 7.373, 6.658, 8.892, and 6.376 respectively, P<0.05).
Conclusions: An understanding of the above high-risk factors for the complications of upper gastrointestinal foreign bodies is helpful to choose appropriate intervention methods and thus reduce the incidence of serious complications.
目的: 探讨儿童上消化道异物引起的并发症及相关危险因素。
方法: 收集2014年1月至2018年12月门诊或住院治疗的上消化道异物患儿772例的临床资料进行分析，通过多因素logistic回归分析上消化道异物患儿发生并发症的危险因素。
结果: 772例患儿异物均由电子胃镜取出，男414例，女358例，中位年龄2.8岁。消化道异物主要发生在年龄 < 3岁婴幼儿组(59.5%)；异物主要分布于食管段(57.5%)和胃内(28.9%)；异物滞留时间≤24 h 465例(60.2%)，> 24 h 307例(39.8%)。异物的类型主要为圆形金属异物(37.2%)、长条形异物(24.7%)、尖锐异物(16.2%)、电池(14.4%)、腐蚀性物质(4.8%)和磁铁(2.7%)。根据并发症发生情况分为轻度并发症(368例，47.7%)、严重并发症(98例，12.7%)及无并发症(306例，39.6%)。经logistic回归分析结果显示，年龄 < 3岁、基础疾病、异物位置、异物类型、异物滞留时间> 24 h是引起上消化道异物并发症发生的危险因素(分别OR=2.141、7.373、6.658、8.892、6.376，P < 0.05)。
结论: 通过对上述导致消化道异物并发症的高危因素地了解，在临床上及时准确地选择恰当的干预方式，可降低各类严重并发症的发生。