ERCP术后LC难易程度评分系统的建立

发布时间：2018-05-29 19:51

  本文选题：胆囊结石 + 胆总管结石　； 参考：《山东医药》2017年25期

【摘要】：目的根据术前临床资料建立胆囊结石合并胆总管结石患者逆行性胰胆管造影术(ERCP)术后行腹腔镜胆囊切除术(LC)中转开腹胆囊切除术的评分系统。方法选取80例胆囊结石合并胆总管结石患者,根据其ERCP术后行LC是否中转开腹分为中转组与非中转组,并对两组术前临床资料进行单因素分析,筛选出中转开腹危险因素,再对其进行Logistic多元回归分析,得出中转开腹的独立危险因素,再对该危险因素进行赋值,建立预测LC术中转开腹可能性的评分系统。结果术前1~3 d的CRP(10 mg/L)、血清淀粉酶(125 U/L)、凝血酶原时间(14 s)、符合SIRS标准为胆囊结石合并胆总管结石患者行LC术中转开腹胆囊切除术的独立危险因素,并分别被赋值后(CRP10 mg/L为6,≤10为0;血清淀粉酶125 U/L为9,≤125 U/L为0;凝血酶原时间14 s为8,≤14 s为0;符合SIRS标准为10,不符符合SIRS标准为0),建立中转开腹胆囊切除术的评分系统(0分组;1~10分组;11~20分组;21~30分组;30分以上组。相邻两组的实际中转率比较差异有统计学意义(P0.05)。结论成功建立了腹腔镜与术前十二指肠镜联合治疗胆囊结石合并胆总管结石EST术后LC术中转开腹风险的评分系统。该系统评分越高,中转开腹的可能性越大。
[Abstract]:Objective to establish a scoring system for conversion from laparoscopic cholecystectomy (LC) to open cholecystectomy (LC) after retrograde cholangiopancreatography (ERCP) in patients with cholecystolithiasis and choledocholithiasis. Methods Eighty patients with cholecystolithiasis complicated with choledocholithiasis were divided into two groups according to whether or not LC was converted to laparotomy after ERCP. The clinical data of the two groups were analyzed by single factor analysis before operation, and the risk factors of conversion to laparotomy were screened out. The Logistic multiple regression analysis was carried out, and the independent risk factor of conversion to open operation was obtained, and the evaluation system was established to predict the possibility of conversion to open surgery during LC. Results CRP(10 mg / L, serum amylase 125U / L and prothrombin time (14 s / L) were found to be the independent risk factors for patients with cholecystolithiasis complicated with choledocholithiasis during LC operation. The CRP10 mg/L was 6, 鈮，

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