Rodrigo Duarte-Chavez, Jill Stoltzfus, Daniel Marino, Kimberly Chaput, Maher El Chaar
Department of Medicine, Division of Gastroenterology, St. Luke's University Health Network, 801 Ostrum Street, Bethlehem, PA, 18015, USA.
Department of Research, St. Luke's University Health Network, 801 Ostrum Street, Bethlehem, PA, 18015, USA.
Obes Surg. 2020 Dec;30(12):4821-4827. doi: 10.1007/s11695-020-04960-z. Epub 2020 Sep 16.
Marginal ulcer is one of the most common complications after Roux-en-Y gastric bypass and is defined as an ulceration of any depth at or near the gastrojejunal anastomosis. Different risk factors have been advocated to be the causative agent.
The weighted discharges from the Nationwide Inpatient Sample from 2003 to 2011 were used to assess for risk factors to develop marginal ulcer such as Helicobacter pylori infection, chronic nonsteroidal anti-inflammatory use, chronic aspirin use, alcohol dependence, smoking, hypertension, and diabetes mellitus type II.
Chronic nonsteroidal anti-inflammatory drug use was the most significant risk factor for marginal ulcer, followed by Helicobacter pylori infection, obstructive sleep apnea, female sex, smoking, and alcohol dependence in decreasing order. Diabetes mellitus and hypertension were found to slightly increase the risk for marginal ulcer. The use of aspirin was found to be a minor risk factor during univariate analysis but a protective factor during multivariate analysis.
Multiple well-documented single factors are related to the genesis of a marginal ulcer, although it is likely that a combination of risk factors is responsible for this problem. These risk factors should be identified and removed or controlled.
边缘性溃疡是Roux-en-Y胃旁路术后最常见的并发症之一，定义为胃空肠吻合口处或其附近任何深度的溃疡。不同的风险因素被认为是其致病因素。
使用2003年至2011年全国住院患者样本的加权出院数据，评估发生边缘性溃疡的风险因素，如幽门螺杆菌感染、慢性非甾体抗炎药使用、慢性阿司匹林使用、酒精依赖、吸烟、高血压和II型糖尿病。
慢性非甾体抗炎药的使用是边缘性溃疡最显著的风险因素，其次依次为幽门螺杆菌感染、阻塞性睡眠呼吸暂停、女性、吸烟和酒精依赖。发现糖尿病和高血压会略微增加边缘性溃疡的风险。在单因素分析中，阿司匹林的使用被发现是一个次要风险因素，但在多因素分析中是一个保护因素。
多个有充分记录的单一因素与边缘性溃疡的发生有关，尽管很可能是多种风险因素共同导致了这个问题。这些风险因素应该被识别并消除或控制。
