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CT诊断的肺炎与胃肿瘤内镜黏膜下剥离术之间的关联

Association between CT-Diagnosed Pneumonia and Endoscopic Submucosal Dissection of Gastric Neoplasms.

作者信息

Fujita Isao, Toyokawa Tatsuya, Matsueda Katsunori, Omote Shizuma, Fujita Akiko, Ueda Yuya, Endo Shinya, Omote Rika, Watanabe Kazuo, Horii Joichiro, Murakami Takako, Tomoda Jun

机构信息

Department of Gastroenterology, National Hospital Organization, Fukuyama Medical Center, Hiroshima, Japan.

出版信息

Digestion. 2016;94(1):37-43. doi: 10.1159/000448134. Epub 2016 Jul 21.

Abstract

BACKGROUND/AIMS: This prospective cohort study aimed to elucidate the incidence and characteristics of pneumonia associated with endoscopic submucosal dissection (ESD) of gastric neoplasms using CT.

METHODS

We included consecutive 188 patients with gastric neoplasms treated with ESD. All patients underwent CT before ESD and the day after ESD. Pneumonia associated with ESD was defined as lung ground glass opacity or consolidation by CT the day after ESD.

RESULTS

In 188 patients, 28 patients had diabetes mellitus. Pneumonia was observed by CT in 21 patients (11.2%) after ESD. Of those, 7 patients had diabetes mellitus. By univariate analysis, compared with patients with non-pneumonia complications, risk factors for pneumonia were significantly increased in patients with diabetes mellitus (p = 0.01) and in those who underwent a long procedure time (p = 0.02). By multivariate analysis, pneumonia was significantly increased in patients with diabetes mellitus (OR 4.06, 95% CI 1.35-12.19) and in those who underwent a long procedure time (OR 1.01, 95% CI 1.00-1.02).

CONCLUSIONS

The incidence of CT-diagnosed pneumonia associated with ESD was relatively high. Furthermore, it was revealed that diabetes mellitus and a long procedure time were risk factors of CT-diagnosed pneumonia.

摘要

背景/目的:这项前瞻性队列研究旨在通过CT阐明胃肿瘤内镜黏膜下剥离术(ESD)相关肺炎的发生率和特征。

方法

我们纳入了连续188例行ESD治疗的胃肿瘤患者。所有患者在ESD术前及术后第1天均接受了CT检查。ESD相关肺炎定义为ESD术后第1天CT显示的肺磨玻璃影或实变。

结果

188例患者中,28例患有糖尿病。ESD术后通过CT观察到21例(11.2%)患者发生肺炎。其中,7例患有糖尿病。单因素分析显示,与无肺炎并发症的患者相比,糖尿病患者(p = 0.01)和手术时间长的患者(p = 0.02)发生肺炎的危险因素显著增加。多因素分析显示,糖尿病患者(OR 4.06,95%CI 1.35 - 12.19)和手术时间长的患者(OR 1.01,95%CI 1.00 - 1.02)发生肺炎的风险显著增加。

结论

CT诊断的ESD相关肺炎发生率相对较高。此外,研究表明糖尿病和手术时间长是CT诊断肺炎的危险因素。

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