摘要
目的探讨化脓性胆管炎和胆源性胰腺炎与内镜下括约肌切开术(EST)、胆管支架等因素的相关性。方法回顾性分析2012年1月至2014年12月行内镜逆行胰胆管造影术的201例胆道梗阻患者的临床资料,对化脓性胆管炎的EST后、胆管支架置入术后危险因素进行单因素分析,对差异有统计学意义的因素进行Logistic回归分析;对胆源性胰腺炎的EST后、胆管塑料支架置入术后和胆管金属支架置入术后3个因素进行单因素分析。结果胆道低位梗阻发生化脓性胆管炎的独立危险因素是中性粒细胞比例、直接胆红素、结石嵌顿和肝内胆管扩张(P<0.05);与EST后、胆管支架置入术后差异无统计学意义;胆道高位梗阻发生化脓性胆管炎与调查的因素差异均无统计学意义;EST后和胆管支架置入术后是胆源性胰腺炎的保护因素(P<0.05)。结论中性粒细胞比例、直接胆红素、结石嵌顿、肝内胆管扩张是胆道低位梗阻发生化脓性胆管炎的独立危险因素;EST后和胆管支架置入术后不会增加化脓性胆管炎的风险,反而能降低胆源性胰腺炎发病率。
Objective To investigate the relationship between suppurative cholangitis, biliary pancreatitis and endoscopic sphincterotomy （EST） ,biliary stent and other relevant factors. Methods We retrospectively analyzed clinical data of 201 cases with biliary obstruction who underwent endoscopic retrograde eholangiopancreatography in General Hospital of Sheny- ang Military Region from January, 2012 to December,2014. In the aspect of suppurative cholangitis, single factor analysis were performed on after EST, biliary stent placement and traditional risk factors, then the statistically significant factors were analyzed by Logistic regression analysis. In the aspect of biliary panereatitis, single factor analysis was performed after EST, biliary plastic stent placement and biliary metal stent placement. Results The suppurative cholangitis of low level biliary obstruction was associated with neutrophil percentage, direct bilirubin, incarcerated common bile duct stones and intrahepat- ic bile duct dilatation （ P 〈 0.05 ）, but not associated with postoperation of EST and biliary stent placement. The suppurative cholangitis of high level biliary obstruction was not associated with the factors surveyed. Postoperation of EST and biliary stent placement were protective factors for biliary pancreatitis （ P 〈 0.05）. Conclusion The suppurative cholangitis of low level biliary obstruction is associated with neutrophil percentage, direct bilirubin,incarcerated common bile duct stones and intrahepatic bile duct dilatation. Postoperation of EST and biliary stent placement will not increase the risk of suppurative cholangitis, but can reduce the incidence of biliary pancreatitis.
出处
《创伤与急危重病医学》
2015年第5期297-300,共4页
Trauma and Critical Care Medicine
