ERCP术后胆管炎相关危险因素分析

发布时间：2018-01-03 17:43

本文关键词：ERCP术后胆管炎相关危险因素分析　出处：《胃肠病学》2016年07期 　论文类型：期刊论文

【摘要】：背景:内镜逆行胰胆管造影术(ERCP)是诊治肝胆胰疾病不可或缺的内镜技术,该技术手术创伤较小,但操作风险极大。目的:分析ERCP术后胆管炎的相关危险因素,并探讨其预防策略。方法:回顾性连续性收集2008年1月—2013年12月在南京鼓楼医院接受ERCP诊治的患者,采集患者相关和ERCP操作相关因素,以χ~2检验或Fisher精确概率法行单因素分析,有统计学意义者进入多因素Logistic回归分析,以明确ERCP术后胆管炎相关危险因素。结果:共4 234例患者纳入研究,插管成功率为96.81%,ERCP术后胆管炎发生率为2.41%,最易发生的高危时间段为术后24~48 h。单因素分析显示年龄、高血压病、糖尿病、既往ERCP术史、胆管支架、胰管造影、乳头肌切开、球囊扩张、内镜取石、梗阻部位与ERCP术后胆管炎有关(P0.05);多因素分析显示高龄、既往ERCP术史、肝门部梗阻为ERCP术后胆管炎的独立危险因素(P0.05),而内镜取石为其保护因素(P0.05)。结论:ERCP术后胆管炎的发生与多种因素有关,术后胆道引流不畅为其核心因素。术前对患者进行充分评估、严格掌握适应证以及规范的操作和正确的围手术期处理有助于预防ERCP术后胆管炎发生。
[Abstract]:Background: endoscopic retrograde cholangiopancreatography (ERCP) is an indispensable endoscopic technique for the diagnosis and treatment of hepatobiliary and pancreatic diseases. Objective: to analyze the risk factors of cholangitis after ERCP. Methods: from January 2008 to December 2013, the patients who were treated with ERCP in Nanjing Gulou Hospital were collected retrospectively. The factors related to patient correlation and ERCP operation were collected and univariate analysis was performed by 蠂 ~ 2 test or Fisher accurate probability method. Those with statistical significance entered multivariate Logistic regression analysis. Results: a total of 4 234 patients were included in the study, the successful rate of intubation was 96.81% and the incidence of cholangitis after ERCP was 2.41%. Univariate analysis showed age, hypertension, diabetes, previous ERCP procedure, biliary stents, pancreatic duct angiography, papillary muscle incision and balloon dilation. Endoscopic lithotomy and obstruction were associated with cholangitis after ERCP. Multivariate analysis showed that old age, history of ERCP operation and hilar obstruction were the independent risk factors of cholangitis after ERCP (P0.05). Conclusion the occurrence of cholangitis after the operation of 20% ERCP is related to many factors, and the obstruction of postoperative biliary drainage is the core factor. The patients were fully evaluated before operation. [WT5 "HZ] [WT5" HZ] [WT5 "BZ] [WT5" BZ] [WT5 "BZ]. Strict indication, standard operation and proper perioperative management are helpful to prevent cholangitis after ERCP.
【作者单位】：南京大学医学院附属鼓楼医院消化科;南京医科大学第二附属医院胃肠外科;
【基金】：南京市医学科技发展项目医学重点科技发展项目(ZKX11022);南京市医学科技发展项目医药卫生科研课题(YKK12053);南京市医学科技发展项目杰出青年基金项目(JQX14005) 南京市科技发展计划项目(201108022)
【分类号】：R657.45
【正文快照】： 背景:内镜逆行胰胆管造影术(ERCP)是诊治肝胆胰疾病不可或缺的内镜技术,该技术手术创伤较小,但操作风险极大。目的:分析ERCP术后胆管炎的相关危险因素,并探讨其预防策略。方法:回顾性连续性收集2008年1月—2013年12月在南京鼓楼医院接受ERCP诊治的患者,采集患者相关和ERCP操作

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