發(fā)布時間：2018-01-27 04:49

  本文關鍵詞： 膽總管結石 ERCP 急性胰腺炎 危險因素 Logistic回歸分析　出處：《廣西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討治療性ERCP術后發(fā)生急性胰腺炎的相關危險因素,為預防術后急性胰腺炎的發(fā)生提供依據(jù)。方法:回顧性分析2014年5月至2016年6月廣西醫(yī)科大學第一附屬醫(yī)院消化內(nèi)科和普通外科共282例膽總管結石患者行ERCP治療的臨床資料。收集患者自身相關因素和術中操作相關因素,采用SPSS17.0統(tǒng)計軟件進行單因素χ2檢驗和多因素logistic回歸分析,篩選出治療性ERCP術后發(fā)生急性胰腺炎的獨立危險因素。結果:282例膽總管結石患者ERCP術后發(fā)生急性胰腺炎共15例,發(fā)生率為5.32%。單因素χ2檢驗得出:十二指腸憩室(χ2=10.421,P=0.001)、插管困難(χ2=16.130,P=0.001)、胰管顯影(χ2=6.342,P=0.012)、操作時間(χ2=6.952,P=0.008)與ERCP術后胰腺炎的發(fā)生有關(P值0.05)。多因素分析結果顯示:插管困難(OR=11.166,P=0.002)和胰管顯影(OR=14.270,P=0.003)是ERCP術后發(fā)生急性胰腺炎的危險因素。結論:十二指腸憩室、插管困難、胰管顯影、操作時間與ERCP術后急性胰腺炎的發(fā)生有關。插管困難和胰管顯影是影響ERCP術后發(fā)生急性胰腺炎的獨立危險因素。通過分析這些危險因素,為臨床預防提供了依據(jù),有利于降低ERCP術后急性胰腺炎的發(fā)生,減少醫(yī)療成本,減輕患者痛苦。
[Abstract]:Objective: to investigate the risk factors of acute pancreatitis after therapeutic ERCP. Methods: to provide evidence for prevention of postoperative acute pancreatitis. The clinical data of 282 patients with choledocholithiasis treated with ERCP from May 2014 to June 2016 in Department of Digestive Medicine and General surgery of the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. Self-related factors and operative related factors. Univariate 蠂 2 test and multivariate logistic regression analysis were performed with SPSS17.0 software. The independent risk factors of acute pancreatitis after ERCP were screened out. Results 15 cases of acute pancreatitis occurred after ERCP in 282 cases of choledocholithiasis. The incidence rate was 5.32.The single factor 蠂 2 test showed that the duodenal diverticulum (蠂 2 + 10.421) was 0.001, and the intubation was difficult (蠂 2 ~ (2) 16.130 / P ~ (0.001)). Pancreatic duct was developed (蠂 ~ 2 ~ (6.342)) and operation time was (蠂 ~ (2) ~ (6.952)). P0. 008) was related to the occurrence of pancreatitis after ERCP. The results of multivariate analysis showed that it was difficult to intubate. Conclusion: duodenal diverticulum is difficult to intubate. Pancreatic duct development. The operative time was related to the occurrence of acute pancreatitis after ERCP. The difficulty of intubation and the development of pancreatic duct were independent risk factors for acute pancreatitis after ERCP. It is helpful to reduce the incidence of acute pancreatitis after ERCP, reduce the cost of medical treatment and alleviate the suffering of patients.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R576

【參考文獻】

相關期刊論文 前10條

1 朱端權;王運兵;龔建平;;鼻膽管引流預防內(nèi)鏡逆行胰膽管造影術后高淀粉酶血癥及胰腺炎療效的Meta分析[J];實用醫(yī)學雜志;2015年17期

2 姜小斌;勵雄年;方玉明;;膽總管結石繼發(fā)急性膽管炎患者血清前白蛋白臨床意義分析[J];現(xiàn)代實用醫(yī)學;2015年08期

3 郝建宏;許明輝;郝素平;張愛飛;姚晶;;氣囊擴張時間對內(nèi)鏡下乳頭氣囊擴張術治療膽總管小結石(<10mm)的影響[J];中國內(nèi)鏡雜志;2015年07期

4 劉苗;鄧濤;楊艷;林萍;汪維波;;鼻膽管引流預防內(nèi)鏡逆行胰膽管造影術后胰腺炎及高淀粉酶血癥療效的Meta分析[J];胃腸病學和肝病學雜志;2015年05期

5 王景波;朱洪春;王長杰;;內(nèi)鏡下乳頭括約肌小切開聯(lián)合氣囊擴張術治療膽總管結石臨床體會[J];臨床消化病雜志;2012年04期

6 王蒙;王廣義;杜曉宏;呂國悅;馮秋實;;老年患者治療性ERCP的危險因素分析[J];中國老年學雜志;2012年15期

7 杜波;王健;但杰;;ERCP術后相關并發(fā)癥的分析與防治[J];中國實用醫(yī)藥;2012年21期

8 矯太偉;孫明軍;;ERCP術后胰腺炎與EST關系及其危險因素評價[J];生物醫(yī)學工程與臨床;2012年03期

9 陳小微;洪萬東;吳小麗;黃慶科;朱啟槐;;治療性ERCP術后胰腺炎危險因素的Logistic回歸分析[J];實用醫(yī)學雜志;2012年04期

10 張中文;蔣兆彥;韓天權;雷若慶;;膽石病的流行病學和危險因素[J];外科理論與實踐;2011年04期

，

本文編號：1467614