回顾性分析成人上消化道尖锐异物内镜下取出术并发症发生情况，并探讨其危险因素。

纳入2021年3月至2025年3月北京市平谷区医院收治的成人上消化道尖锐异物内镜下取出术患者资料进行回顾性分析，其中有并发症患者29例（穿孔8例、出血9例、脓肿7例、溃疡5例），无并发症患者188例。比较2组患者年龄、性别、基础疾病、异物大小与形状、部位、滞留时间、内镜医师经验、辅助器械选择及术前黏膜损伤、手术时间、抗生素使用情况，运用Logistic多因素回归分析和受试者工作特征曲线（ROC），分析上述因素对成人上消化道尖锐异物内镜下取出术并发症发生的预测价值。

两组患者的年龄、合并高血压、异物大小、异物形状、异物部位、滞留时间、术前黏膜损伤方面比较，差异均有统计学意义（P<0.05）。多因素Logistic回归分析显示，年龄>48岁、合并高血压、异物大小>22 mm、异物形状为针/鱼刺、滞留时间>16 h、术前黏膜损伤、异物部位为食管上段均为影响成人上消化道尖锐异物术后并发症的独立危险因素（P<0.05）。ROC曲线分析，年龄>48岁、合并高血压、异物大小>22 mm、异物形状为针/鱼刺、滞留时间>16 h、术前黏膜损伤、异物部位为食管上段等指标联合预测成人上消化道尖锐异物术后并发症的AUC为0.872，其灵敏度和特异性分别为85.10%和83.61%。

成人上消化道尖锐异物内镜下取出术患者并发症与年龄、合并高血压、异物大小、异物形状、异物部位、滞留时间、术前黏膜损伤均存在密切关联，联合监测上述因素能够为并发症预防和干预提供可靠参考。

To retrospectively analyze the occurrence of complications in endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract of adults and explore its risk factors.

A retrospective analysis was conducted on the data of adult patients who underwent endoscopic removal of sharp foreign bodies in the upper digestive tract at Pinggu District Hospital of Beijing from March 2021 to March 2025. Among them, 29 patients had complications (8 cases of perforation, 9 cases of bleeding, 7 cases of abscess, 5 cases of ulcer), and 188 patients had no complications. The age, gender, underlying diseases, size and shape of foreign bodies, location, retention time, endoscopy physician experience, selection of auxiliary instruments, preoperative mucosal injury, operation time, and antibiotic use of the two groups of patients were compared. Logistic multivariate regression analysis and receiver operating characteristic (ROC) curve were used to analyze the predictive value of the above factors for the occurrence of complications during endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract of adults.

There were statistically significant differences between the two groups in terms of age, combined hypertension, foreign body size, foreign body shape, foreign body location, retention time, and preoperative mucosal injury (P<0.05). Multivariate Logistic regression analysis showed that age >48 years old, combined hypertension, foreign body size >22 mm, foreign body shape of needle/fish bone, retention time >16 hours, preoperative mucosal injury, and foreign body location in the upper segment of the esophagus were all independent risk factors affecting postoperative complications of sharp foreign bodies in the upper digestive tract of adults (P<0.05). ROC curve analysis showed that the combined AUC of indicators such as age >48 years, combined hypertension, foreign body size >22 mm, foreign body shape of needle/fish bone, retention time >16 hours, preoperative mucosal injury, and foreign body location in the upper segment of the esophagus for predicting postoperative complications of sharp foreign bodies in the upper gastrointestinal tract of adults was 0.872. Its sensitivity and specificity were 85.10% and 83.61% respectively.

Complications in adult patients undergoing endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract are closely related to age, combined hypertension, foreign body size, foreign body shape, foreign body location, retention time, and preoperative mucosal injury, combined monitoring of the above factors can provide a reliable reference for the prevention and intervention of complications.