经内镜逆行胰胆管造影术治疗老年胆总管结石的临床疗效

发布时间：2018-11-06 19:20

【摘要】：目的探讨经内镜逆行胰胆管造影术(ERCP)治疗老年胆总管结石的临床疗效及术后并发症的影响因素。方法回顾性分析136例行ERCP治疗的老年胆总管结石患者的临床资料,分析其临床疗效及术后并发症发生的影响因素。结果 136例老年胆总管结石患者经ERCP治疗后,取石成功率和取净率均为100%,住院时间、疼痛缓解时间和抗感染治疗时间方面均较显著。经单因素、多因素Logistic回归分析,括约肌功能障碍(SOD)病史(OR=1.318,95%CI=1.114~4.926)、胰管显影(OR=1.101,95%CI=1.022~2.731)和插管时间60 min(OR=1.026,95%CI=1.016~3.769)为影响ERCP治疗老年胆总管结石术后并发胰腺炎的主要危险因素;胆道结石病史(OR=1.249,95%CI=1.105~3.621)、胆道中高位梗阻(OR=1.412,95%CI=1.263~4.788)和胆管治疗史(OR=1.281,95%CI=1.051~2.871)为影响ERCP治疗老年胆总管结石术后并发胆道感染的主要危险因素。结论 ERCP治疗老年胆总管结石疗效显著,术后并发症影响因素主要为SOD病史、胰管显影、插管时间、胆道中高位梗阻、胆道结石病史和胆管治疗史。
[Abstract]:Objective to investigate the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of choledocholithiasis in the elderly and the influencing factors of postoperative complications. Methods the clinical data of the elderly patients with choledocholithiasis treated with ERCP were analyzed retrospectively. Results after ERCP treatment, the success rate and net rate of choledocholithiasis were 100. The time of hospitalization, pain relief and anti-infection treatment were significant. By univariate and multivariate Logistic regression analysis, (SOD) history of sphincter dysfunction (OR=1.318,95%CI=1.114~4.926) was found. Pancreatic duct development (OR=1.101,95%CI=1.022~2.731) and intubation time of 60 min (OR=1.026,95%CI=1.016~3.769) were the main risk factors for the treatment of pancreatitis after ERCP in elderly patients with choledocholithiasis. History of cholelithiasis (OR=1.249,95%CI=1.105~3.621), Middle and high bile duct obstruction (OR=1.412,95%CI=1.263~4.788) and history of bile duct therapy (OR=1.281,95%CI=1.051~2.871) were the main risk factors for ERCP in the treatment of choledocholithiasis complicated with biliary tract infection. Conclusion ERCP is effective in the treatment of choledocholithiasis in the elderly. The influencing factors of postoperative complications are the history of SOD, the development of pancreatic duct, the time of intubation, the obstruction of middle and high bile duct, the history of cholelithiasis and the history of bile duct treatment.
【作者单位】：民航总医院消化内科;
【分类号】：R657.42

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