疼痛性慢性胰腺炎内镜介入治疗无效因素初探  

Risk factors of failure in pain resolution in chronic pancreatitis after endoscopic treatment

作　　者：王伟[1] 廖专[1] 李兆申[1] 赖晓伟[1] 王新涛[1] 邹多武[1] 金震东[1] 柏建岭[2] 

机构地区：[1]第二军医大学附属长海医院消化内科,上海200433 [2]南京医科大学流行病与卫生统计学系

出　　处：《中华消化内镜杂志》2009年第2期60-64,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的 探索内镜介入治疗疼痛性慢性胰腺炎（CP）无效的风险因素。方法分析随访1997年至2006年仅经内镜治疗且存活的疼痛性慢性胰腺炎资料，根据患者临床特征及相关研究资料选择与治疗无效可能相关的风险因素，利用Cox比例风险模型进行逐步回归分析。结果患者中男114例、女58例，平均39．4岁，148例（86．0％）内镜治疗有效。多因素Cox比例风险模型逐步回归显示，首发年龄（〉36岁）、治疗前轻中度腹痛、内镜治疗后酒精摄入量无明显减少和饮食不节为内镜治疗无效的预后因素，风险比分别为3．5、2．4、1．9和2．8。结论疼痛性慢性胰腺炎内镜介入治疗后应戒酒和低脂规律饮食，首发年龄大、腹痛程度相对较轻的患者尤其应当注意。Objective To evaluate the risk factors of failure in pain resolution in chronic pancreatitis （CP） after endoscopic treatment. Methods We undertook a retrospective cohort study of subjects with pain caused by CP, who underwent endoscopic treatment from January 1997 to December 2006. Cox proportional-hazards model was used for multivariate analysis of the variables that were possibly related to failure of treatment. Results Follow-up data were obtained from 172 patients （ 114 males and 58 females, mean age 39. 4 yr. Pain resolution after endoscopic treatment was achieved in 148 （86. 0% ）. Cox proportional-hazards model showed risk factors of failure in pain resolution after endoscopic treatment were onset age （ 〉 36 years, hazard rate （HR） = 3.5 ）, mild and moderate abdominal pain before endoscopy （HR = 2. 4）, no decrease in amount alcohol consume （ 〈 50%, HR = 1.9） and inappropriate diet （ HR = 2. 8 ）. Conclusion Patients with CP should abstain from alcohol and have low-fat diet, especially for those with pain onset at older ages （ 〉 36 years） and with mild and moderate abdominal pain before endoscopic treatment.

关 键 词：胰腺炎 慢性 内窥镜 治疗 风险因素 

分 类 号：R57[医药卫生—消化系统]