ERCP治疗胆总管结石患者术后再发结石的危险因素分析

发布时间：2019-01-10 12:22

【摘要】：目的:探讨胆总管结石经内镜逆行胰胆管造影(Endoscopic Retrograde Cholangiopancreatography,ERCP)取石术后患者结石再发的危险因素,为临床治疗及预防胆总管结石提供有效措施。方法:收集延边大学附属医院2013年6月-2016年6月期间,226例确诊为胆总管结石并且行ERCP治疗的患者的临床资料,符合标准的病例中分为复发组、未复发组两组,根据一定标准按照性别、年龄、饮食习惯、体质指数、胆道手术史、结石的直径及数量、是否存在十二指肠憩室、是否合并胆总管狭窄、胆总管扩张程度等相关因素进行单因素统计学分析,然后将P0.05的单因素观察值代入Logistic多因素回归分析,计算出P及95%置信区间等统计学数值,最终找到结石复发的独立危险因素。结果:收集的226例病例其中死亡2例,13例无法取得联系,共计211例病例符合标准。符合标准的病例中,有26例ERCP术后结石再发,其复发率为12.32%。经单因素统计分析结果示:复发组和未复发组在胆道手术史(P=0.001)、结石数量(P=0.031)、是否存在十二指肠憩室(P=0.001)、胆总管直径(P=0.005)这四个方面差异均有统计学意义(P0.05)。Logistic回归分析后结果:最后只有三个因素有统计学意义:1.胆道手术史(OR:3.211,95%CI:1.329-7.760,P=0.010)2.胆总管直径≥15mm(OR:3.268,95%CI:1.179-9.062,P=0.023)3.合并十二指肠憩室(OR:4.336,95%CI:1.525-12.329,P=0.006)结论:患者既往有胆道手术史、合并十二指肠憩室、胆总管直径≥15mm是胆总管结石患者行ERCP术后结石再发的危险因素。
[Abstract]:Objective: to explore the risk factors for the recurrence of choledocholithiasis after endoscopic retrograde cholangiopancreatography (Endoscopic Retrograde Cholangiopancreatography,ERCP) in order to provide effective measures for clinical treatment and prevention of choledocholithiasis. Methods: the clinical data of 226 patients with choledocholithiasis diagnosed and treated with ERCP from June 2013 to June 2016 in affiliated Hospital of Yanbian University were collected. According to certain criteria, according to sex, age, eating habits, body mass index, history of biliary tract surgery, diameter and number of stones, whether duodenal diverticulum exists or not, whether there is common bile duct stenosis, The degree of choledochus dilatation and other related factors were analyzed by univariate statistical analysis, and then the observation value of P05 was replaced by Logistic multivariate regression analysis, and the statistical values such as P and 95% confidence interval were calculated. Finally, independent risk factors for recurrence of stones were found. Results: among 226 cases, 2 cases died, 13 cases could not be contacted. A total of 211 cases met the standard. Among the patients who met the criteria, 26 patients had recurrent stones after ERCP, and the recurrence rate was 12.32. The results of univariate statistical analysis showed that the history of biliary tract surgery (P0. 001), the number of stones (P0. 031), and the presence of duodenal diverticulum (P0. 001) were found in recurrent and non recurrent groups. The differences of common bile duct diameter (P0. 005) were statistically significant (P0.05). Logistic regression analysis results: the last three factors were statistically significant: 1. History of biliary tract surgery (OR:3.211,95%CI:1.329-7.760,P=0.010) 2. The diameter of common bile duct 鈮，

本文编号：2406303