治疗性ERCP术后发生急性胰腺炎的危险因素分析

发布时间：2018-01-27 04:49

本文关键词： 胆总管结石 ERCP 急性胰腺炎危险因素 Logistic回归分析　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨治疗性ERCP术后发生急性胰腺炎的相关危险因素,为预防术后急性胰腺炎的发生提供依据。方法:回顾性分析2014年5月至2016年6月广西医科大学第一附属医院消化内科和普通外科共282例胆总管结石患者行ERCP治疗的临床资料。收集患者自身相关因素和术中操作相关因素,采用SPSS17.0统计软件进行单因素χ2检验和多因素logistic回归分析,筛选出治疗性ERCP术后发生急性胰腺炎的独立危险因素。结果:282例胆总管结石患者ERCP术后发生急性胰腺炎共15例,发生率为5.32%。单因素χ2检验得出:十二指肠憩室(χ2=10.421,P=0.001)、插管困难(χ2=16.130,P=0.001)、胰管显影(χ2=6.342,P=0.012)、操作时间(χ2=6.952,P=0.008)与ERCP术后胰腺炎的发生有关(P值0.05)。多因素分析结果显示:插管困难(OR=11.166,P=0.002)和胰管显影(OR=14.270,P=0.003)是ERCP术后发生急性胰腺炎的危险因素。结论:十二指肠憩室、插管困难、胰管显影、操作时间与ERCP术后急性胰腺炎的发生有关。插管困难和胰管显影是影响ERCP术后发生急性胰腺炎的独立危险因素。通过分析这些危险因素,为临床预防提供了依据,有利于降低ERCP术后急性胰腺炎的发生,减少医疗成本,减轻患者痛苦。
[Abstract]:Objective: to investigate the risk factors of acute pancreatitis after therapeutic ERCP. Methods: to provide evidence for prevention of postoperative acute pancreatitis. The clinical data of 282 patients with choledocholithiasis treated with ERCP from May 2014 to June 2016 in Department of Digestive Medicine and General surgery of the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. Self-related factors and operative related factors. Univariate 蠂 2 test and multivariate logistic regression analysis were performed with SPSS17.0 software. The independent risk factors of acute pancreatitis after ERCP were screened out. Results 15 cases of acute pancreatitis occurred after ERCP in 282 cases of choledocholithiasis. The incidence rate was 5.32.The single factor 蠂 2 test showed that the duodenal diverticulum (蠂 2 + 10.421) was 0.001, and the intubation was difficult (蠂 2 ~ (2) 16.130 / P ~ (0.001)). Pancreatic duct was developed (蠂 ~ 2 ~ (6.342)) and operation time was (蠂 ~ (2) ~ (6.952)). P0. 008) was related to the occurrence of pancreatitis after ERCP. The results of multivariate analysis showed that it was difficult to intubate. Conclusion: duodenal diverticulum is difficult to intubate. Pancreatic duct development. The operative time was related to the occurrence of acute pancreatitis after ERCP. The difficulty of intubation and the development of pancreatic duct were independent risk factors for acute pancreatitis after ERCP. It is helpful to reduce the incidence of acute pancreatitis after ERCP, reduce the cost of medical treatment and alleviate the suffering of patients.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R576

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