Lai A T Y, Chow T L, Lee D T Y, Kwok S P Y
Department of Surgery, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong, China.
Br J Surg. 2003 Dec;90(12):1531-5. doi: 10.1002/bjs.4356.
The aim of this study was to determine the predictive risk factors for complications resulting from foreign body ingestion.
A consecutive series of 1338 patients with suspected foreign body ingestion presenting from 1996 to 2000 were studied retrospectively. The potential risk factors for complications after foreign body ingestion were analysed by multivariate logistic regression and included concurrent medical illness, age, duration and types of symptoms, types of foreign body ingested, positive cervical radiographic findings and the level of foreign body impaction.
Fish bone (62.7 per cent) was the commonest type of foreign body ingested. Most of the objects were impacted at or above the cricopharyngeus, the commonest site being the valleculae (31.4 per cent). Multivariate analysis showed that presentation delayed for more than 2 days (P < 0.001), positive cervical radiographic findings (P < 0.001) and foreign body impacted at the cricopharyngeus (P = 0.009) or upper oesophagus (P = 0.005) were significant independent risk factors associated with the development of complications after foreign body ingestion.
In patients with a foreign body seen on plain cervical radiography, presentation delayed for more than 2 days after ingestion, and foreign body impacted at the level of the cricopharyngeus or oesophagus there is a high degree of correlation with the occurrence of complications. Awareness should be raised when these risk factors are present.
本研究旨在确定异物吞食所致并发症的预测性风险因素。
回顾性研究了1996年至2000年间连续收治的1338例疑似异物吞食患者。通过多因素逻辑回归分析异物吞食后并发症的潜在风险因素，包括并存疾病、年龄、症状持续时间和类型、吞食异物的类型、颈椎X线检查阳性结果以及异物嵌顿部位。
鱼骨（62.7%）是最常见的吞食异物类型。大多数异物嵌顿于环咽肌或其上方，最常见部位是会厌谷（31.4%）。多因素分析显示，吞食后就诊延迟超过2天（P<0.001）、颈椎X线检查阳性结果（P<0.001）以及异物嵌顿于环咽肌（P = 0.009）或食管上段（P = 0.005）是异物吞食后并发症发生的显著独立风险因素。
在颈椎平片上发现有异物的患者中，吞食后就诊延迟超过2天以及异物嵌顿于环咽肌或食管水平与并发症的发生高度相关。当存在这些风险因素时应提高警惕。
