肝硬化患者内镜逆行胰胆管造影术后并发症评分系统的建立
发布时间：2019-04-15 20:10
【摘要】：目的分析肝硬化患者行内镜逆行胰胆管造影(ERCP)术后并发症的危险因素,建立简单、实用的评分系统。方法回顾性分析2009年1月至2015年12月223例在第二军医大学长海医院行胆管ERCP同时合并肝硬化患者的临床病理资料。对术后并发症的影响因素,如术前状态、检验指标、术中操作情况等进行单因素分析和logistic回归分析。将独立危险因素中的连续变量转换为分类变量,根据各变量在logistic回归中的β值进行赋值,建立新的评分系统,通过受试者工作特征(ROC)曲线评价其预测并发症的效能。结果 Logistic回归分析发现,总胆红素(TBIL)是术后并发症的独立危险因素(OR=1.003,95%CI:1.001~1.005),白蛋白(ALB)是其保护因素(OR=0.935,95%CI:0.879~0.994)。利用这两项指标建立的评分系统为:TBIL≤31.4μmol/L为0分,31.5~102.5μmol/L为1分,≥102.6μmol/L为2分;ALB≥31 g/L为0分,≤30 g/L为1分。经过ROC曲线分析发现,新建评分的曲线下面积(AUC)为0.689,与ChildPugh分级(AUC:0.700)和终末期肝病模型(MELD)评分(AUC:0.692)相当。当以1.5分为界时(即0~1分为低危,2~3分为高危),新建评分系统的敏感度为89.4%,特异度为41.1%,准确率为49.3%,阳性预测值为23.7%,阴性预测值为95.0%。结论新建的ERCP术后并发症评分系统简便、易用,可以用来区分高危患者。
[Abstract]:Objective to analyze the risk factors of complications after endoscopic retrograde cholangiopancreatography (ERCP) in patients with liver cirrhosis and to establish a simple and practical scoring system. Methods from January 2009 to December 2015, the clinical and pathological data of 223 patients who underwent bile duct ERCP combined with liver cirrhosis in Changhai Hospital, second military Medical University were retrospectively analyzed. Single factor analysis and logistic regression analysis were used to analyze the factors affecting postoperative complications, such as preoperative condition, test indexes, and intraoperative operation. The continuous variables in independent risk factors were converted into classified variables. According to the 尾 values of each variable in logistic regression, a new scoring system was established. The effectiveness of predicting complications was evaluated by using the (ROC) curve of receiver operating characteristics. Results Logistic regression analysis showed that total bilirubin (TBIL) was an independent risk factor for postoperative complications (OR=1.003,95%CI:1.001~1.005) and albumin (ALB) was a protective factor (OR=0.935,95%CI:0.879~0.994). The score system based on these two indexes was 0 for TBIL 31.4 渭 mol / L, 1 for 31.5 ~ 102.5 渭 mol / L, 2 for 鈮，
本文编号：2458454
[Abstract]:Objective to analyze the risk factors of complications after endoscopic retrograde cholangiopancreatography (ERCP) in patients with liver cirrhosis and to establish a simple and practical scoring system. Methods from January 2009 to December 2015, the clinical and pathological data of 223 patients who underwent bile duct ERCP combined with liver cirrhosis in Changhai Hospital, second military Medical University were retrospectively analyzed. Single factor analysis and logistic regression analysis were used to analyze the factors affecting postoperative complications, such as preoperative condition, test indexes, and intraoperative operation. The continuous variables in independent risk factors were converted into classified variables. According to the 尾 values of each variable in logistic regression, a new scoring system was established. The effectiveness of predicting complications was evaluated by using the (ROC) curve of receiver operating characteristics. Results Logistic regression analysis showed that total bilirubin (TBIL) was an independent risk factor for postoperative complications (OR=1.003,95%CI:1.001~1.005) and albumin (ALB) was a protective factor (OR=0.935,95%CI:0.879~0.994). The score system based on these two indexes was 0 for TBIL 31.4 渭 mol / L, 1 for 31.5 ~ 102.5 渭 mol / L, 2 for 鈮，
本文编号：2458454
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