口腔颌面部恶性肿瘤患者术后应激性溃疡出血发生的危险因素评估
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摘要
目的:评估口腔颌面部恶性肿瘤患者术后应激性溃疡出血发生的危险因素。方法:采用回顾性分析的方法,对2014年1月～2017年12月在山西医科大学第一医院口腔科行口腔颌面部恶性肿瘤切除术患者289例,分析患者的流行病学因素、肿瘤因素,合并症因素、围手术期因素、消化道疾病既往史等相关因素,研究发生应激性溃疡出血的危险因素。结果:单因素方差分析显示,与应激性溃疡出血发生密切相关的因素主要有患者年龄、饮酒、BMI、肿瘤体积、肿瘤淋巴结转移、糖尿病、手术时间、输血与消化道疾病既往史。Logistic多元回归分析结果表明,BMI、肿瘤淋巴结转移、糖尿病、手术时间与消化道疾病既往史是预测术后发生应激性溃疡出血的独立危险因素。结论:口腔颌面部恶性肿瘤患者术后应激性溃疡出血发生比较常见,对具备高危因素的患者要积极预防和治疗应激性溃疡出血,对降低口腔颌面部恶性肿瘤术后病死率有着积极的意义。
Objective: To evaluate the risk factors of stress ulcer bleeding development in patients after oral and maxillofacial malignant tumors.Methods: With retrospective analysis method,in January 2014 to December 2017 in the department of stomatology of first hospital of Shanxi Medical University,289 patients with oral and maxillofacial malignant tumor resection,were analyzed with epidemiological factors,tumor factor,complications,perioperative,past medical history related to factors such as gastrointestinal disease to research in the risk factors of stress ulcer bleeding.Results: The results by univariate analysis of variance showed that the factors closely related to the occurrence of stress ulcer bleeding were age,alcohol consumption,BMI,tumor volume,tumor lymph node metastasis,diabetes,operation time,blood transfusion and past history of digestive tract diseases.The results of Logistic multiple regression analysis indicated that BMI,tumor lymph node metastasis,diabetes,operation time and past history of digestive tract diseases were independent risk factors for stress ulcer bleeding.Conclusion: The occurrence of stress ulcer bleeding is relatively common in patients after oral and maxillofacial malignant tumors.It is of positive significance to prevent and treat stress ulcer bleeding in patients with high-risk factors,and to reduce the postoperative mortality of oral and maxillofacial malignant tumors.
Objective: To evaluate the risk factors of stress ulcer bleeding development in patients after oral and maxillofacial malignant tumors.Methods: With retrospective analysis method,in January 2014 to December 2017 in the department of stomatology of first hospital of Shanxi Medical University,289 patients with oral and maxillofacial malignant tumor resection,were analyzed with epidemiological factors,tumor factor,complications,perioperative,past medical history related to factors such as gastrointestinal disease to research in the risk factors of stress ulcer bleeding.Results: The results by univariate analysis of variance showed that the factors closely related to the occurrence of stress ulcer bleeding were age,alcohol consumption,BMI,tumor volume,tumor lymph node metastasis,diabetes,operation time,blood transfusion and past history of digestive tract diseases.The results of Logistic multiple regression analysis indicated that BMI,tumor lymph node metastasis,diabetes,operation time and past history of digestive tract diseases were independent risk factors for stress ulcer bleeding.Conclusion: The occurrence of stress ulcer bleeding is relatively common in patients after oral and maxillofacial malignant tumors.It is of positive significance to prevent and treat stress ulcer bleeding in patients with high-risk factors,and to reduce the postoperative mortality of oral and maxillofacial malignant tumors.
引文
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[10]尹小朋.老年口腔颌面部肿瘤患者围手术期的风险评估与控制[J].国际口腔医学杂志,2010,37(5):573-575,579.
[2]Qui W,Zheng J.Development of oral and maxillofacial oncology in China[J].Chin Med J(Engl),2003,116(10):1567-1573.
[3]廖贵清,苏宇雄.口腔颌面部恶性肿瘤的多学科综合序列治疗[J].中华口腔医学研究杂志(电子版),2011,5(1):1-4.
[4]Kokemueller H,Eckardt A,Brachvogel P,et,al.Adenoid cystic carcinoma of the head and neck--a 20 years experience[J].Int J Oral Maxillofac Surg,2004,33(1):25-31.
[5]Greer RO.Pathology of malignant and premalignant oral epithelial lesions[J].Otolaryngol Clin North Am,2006,39(2):249-275.
[6]徐亚娟,刘文书,徐洪斌,等.1000例老年人口腔颌面部肿瘤的回顾分析[J].中国老年学杂志,2009,29(21):2802-2803.
[7]van Leerdam ME,van der Ende A,ten Kate FJ,et,al.Lack of accuracy of the noninvasive Helicobacter pylori stool antigen test in patients with gastroduodenal ulcer bleeding[J].Am J Gastroenterol,2003,98(4):798-801.
[8]Cheung FK,Lau JY.Management of massive peptic ulcer bleeding[J].Gastroenterol Clin North Am,2009,38(2):231-243.
[9]刘莹,金武龙.口腔颌面部恶性肿瘤患者营养风险评估及相关因素分析[J].上海口腔医学,2017,26(6):637-640.
[10]尹小朋.老年口腔颌面部肿瘤患者围手术期的风险评估与控制[J].国际口腔医学杂志,2010,37(5):573-575,579.