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内镜下异物取出术后食管小穿孔患者常规放置鼻胃管可能不必要:一项倾向评分匹配分析

Routine nasogastric tube placement in patients with small esophageal perforation after endoscopic foreign body removal may be unnecessary: a propensity score matching analysis.

作者信息

Liao Foqiang, Yang Qinyu, Zhan Zhenyi, Zhu Zhenhua, Pan Xiaolin, Wang Chong, Li Bimin, Zhu Yin, Chen Youxiang, Shu Xu

机构信息

Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China.

Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China.

出版信息

Gastroenterol Rep (Oxf). 2023 Jul 29;11:goad044. doi: 10.1093/gastro/goad044. eCollection 2023.

DOI:10.1093/gastro/goad044
PMID:37521332
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10386876/
Abstract

BACKGROUND

Nasogastric tube (NGT) placement is part of the post-operative management of upper gastrointestinal perforation, but its routine use in esophageal perforation (EP) caused by foreign bodies remains unclear. The purpose of this research was to investigate the necessity for routine NGT placement in patients with EP after endoscopic foreign body removal.

METHODS

A total of 323 patients diagnosed with EP caused by foreign bodies at the First Affiliated Hospital of Nanchang University between January 2012 and December 2021 were included in this retrospective study. Patients were divided into the NGT group and the non-NGT group according to whether or not NGT placement was performed. The perforation healing rate, post-operative adverse events, hospital stay, and death rate were analysed using a 1:1 propensity score matching model.

RESULTS

Before matching, there were 263 patients in the NGT group and 60 patients in the non-NGT group. There were significant differences in the time to treatment, infection, albumin, and types of endoscopy between the two groups, while the length of hospital stay in the NGT group was significantly longer than that in the non-NGT group. After 1:1 propensity score matching, 48 pairs of patients were matched between the two groups. The perforation healing rate, post-operative adverse events, length of hospital stay, and death rate did not show significant differences between the two groups.

CONCLUSIONS

For patients with small EP caused by foreign bodies, routine NGT placement after endoscopic foreign body removal may be unnecessary.

摘要

背景

鼻胃管(NGT)置入是上消化道穿孔术后管理的一部分,但对于异物所致食管穿孔(EP)常规使用鼻胃管仍不明确。本研究的目的是探讨内镜下异物取出术后EP患者常规置入NGT的必要性。

方法

本回顾性研究纳入了2012年1月至2021年12月在南昌大学第一附属医院诊断为异物所致EP的323例患者。根据是否置入NGT将患者分为NGT组和非NGT组。采用1:1倾向评分匹配模型分析穿孔愈合率、术后不良事件、住院时间和死亡率。

结果

匹配前,NGT组有263例患者,非NGT组有60例患者。两组在治疗时间、感染、白蛋白及内镜类型方面存在显著差异,而NGT组的住院时间明显长于非NGT组。1:1倾向评分匹配后,两组匹配了48对患者。两组的穿孔愈合率、术后不良事件、住院时间和死亡率均无显著差异。

结论

对于异物所致小EP患者,内镜下异物取出术后常规置入NGT可能没有必要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8225/10386876/a4f5378f35ab/goad044f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8225/10386876/f30dd29d9d86/goad044f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8225/10386876/866a482e280f/goad044f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8225/10386876/a4f5378f35ab/goad044f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8225/10386876/f30dd29d9d86/goad044f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8225/10386876/866a482e280f/goad044f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8225/10386876/a4f5378f35ab/goad044f3.jpg

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Front Med (Lausanne). 2022 Feb 22;9:713211. doi: 10.3389/fmed.2022.713211. eCollection 2022.
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Safety and Efficacy of Nonoperative Treatment in Esophageal Perforation Caused by Foreign Bodies.异物导致食管穿孔的非手术治疗的安全性和疗效。
Clin Transl Gastroenterol. 2022 Jan 19;13(1):e00451. doi: 10.14309/ctg.0000000000000451.
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