摘要
目的探讨胆囊结石并发急性胆源性胰腺炎(ABP)的高危因素。方法收集2014年1月-2017年9月因腹痛收入哈尔滨医科大学附属第一医院普外科并确诊为胆囊结石患者的临床资料。计数资料2组间比较采用χ~2检验。多因素分析采用二分类logistic回归分析法。结果共收集700例胆囊结石患者,其中167例并发ABP,发生率23.86%。单因素分析显示,性别、胆囊大小、胆囊壁厚度、胆囊结石大小、胆囊结石多少、有无胆总管结石与是否并发ABP有关(P值均<0.05)。将单因素分析具有统计学差异的因素进行多因素logistic回归分析显示男性[比值比(OR)=1.879,95%可信区间(95%CI):1.279~2.758]、胆囊大小异常(OR=0.282,95%CI:0.184~0.434)、胆囊壁厚度≤3 mm(OR=2.245,95%CI:1.490~3.383)、胆囊结石直径>1 cm(OR=0.438,95%CI:0.249~0.769)、胆囊单发结石(OR=0.222,95%CI:0.130~0.378)、合并胆总管(OR=2.775,95%CI:1.694~4.546)与ABP发生显著相关(P值均<0.05)。结论男性、胆囊大小正常、胆囊壁厚≤3 mm、胆囊结石直径≤1 cm、胆囊多发结石、合并胆总管结石均为胆囊结石患者并发ABP的独立危险因素。
Objective To investigate the risk factors for gallstones complicated by acute biliary pancreatitis（ ABP）. Methods A retrospective analysis was performed for the clinical data of patients who were admitted to Department of General Surgery,The First Affiliated Hospital of Harbin Medical University,from January 2014 to September 2017 due to abdominal pain and then diagnosed with gallstones. The chi-square test was used for comparison of categorical data between groups,and the binary logistic regression analysis was used as multivariate analysis. Results A total of 700 patients with gallstones were enrolled,among whom 167 were complicated by ABP,resulting in an incidence rate of 23. 86%. The univariate analysis showed that sex,gallbladder size,gallbladder wall thickness,gallstone size,the number of gallstones,and presence or absence of common bile duct stones were associated with the development of ABP（ all P 0. 05）. A multivariate analysis was performed for the factors with statistical difference identified by the univariate analysis,and the results showed that male sex（ odds ratio [OR]= 1. 879,95% confidence interval [CI]： 1. 279-2. 758,P 0. 05）,abnormal gallbladder size（ OR = 0. 282,95% CI： 0. 184-0. 434,P 0. 05）,gallbladder wall thickness ≤3 mm（ OR = 2. 245,95% CI： 1. 490-3. 383,P 0. 05）,gallbladder stone diameter 1 cm（ OR = 0. 438,95% CI： 0. 249-0. 769,P 0. 05）,single gallstone（ OR = 0. 222,95% CI： 0. 130-0. 378,P 0. 05）,and presence of common bile duct stones（ OR = 2. 775,95% CI： 1. 694-4. 546,P 0. 05） were significantly associated with the development of ABP. Conclusion Male sex,normal gallbladder size,gallbladder wall thickness ≤3 mm,gallbladder stone diameter ≤1 cm,multiple gallstones,and presence of common bile duct stones are independent risk factors for ABP in patients with gallstones.
作者
王宪鹏
孟宪志
WANG Xianpeng;MENG Xianzhi(Department of Minimally Invasive Biliary Surgery,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2018年第8期1728-1732,共5页
Journal of Clinical Hepatology
关键词
胆囊结石病
胰腺炎
危险因素
cholecystolithiasis
pancreatitis
risk factors
