慢性胰腺炎患者胰管支架堵塞及其相关因素分析  

Risk factors of stent occlusion in chronic pancreatitis

作　　者：王新涛[1] 邹多武[1] 李兆中[1] 廖专[1] 赖晓伟[1] 

机构地区：[1]第二军医大学长海医院消化内科,上海200433

出　　处：《中华胰腺病杂志》2010年第4期227-230,共4页Chinese Journal of Pancreatology

摘　　要：目的分析慢性胰腺炎（chronic panreatitis，CP）患者胰管支架的堵塞率及影响支架通畅的相关因素。方法收集2006年11月至2010年1月间64例CP患者经内镜下取出的胰管支架77根，应用自制的支架通畅率检测装置，在10cm水柱压力下，测15s，连测4次。使用Kaplan—Meier统计方法对风险因子和支架堵塞的相关性进行单变量分析研究。通过Cox regression生存分析法进行风险因子对于支架堵塞风险影响的多因素分析。结果64例CP患者入组，其中男性43例，女性21例，年龄4～80岁，平均38岁。支架置入时间为26～759d，平均263d；支架直径5～10F，平均8F。10cm水柱压力下支架总堵塞率为67．5％（52／77）。90、180、360、540d的通畅率分别为96．1％（74／77）、72．7％（56／77）、58．4％（45／77）和35．1％（27／77）。通过Cox回归分析，支架直径≥8．5F是支架堵塞的唯一的独立风险因素。结论支架放置180d仍有较高的通畅率，明显低于国外相同研究97％的堵塞率；选择t〉8．5F的胰管支架更容易发生堵塞现象。Objective To investigate the stent occlusion rate and its risk factor in chronic pancreatitis （CP）. Methods From November 2006 to January 2010 a total of 77 pancreatic endoprostheses from 64 patients with CP were tested by simulating the pathophysiologically increased main pancreatic duct （ MPD ） pressure. The water flow during 15 seconds was recorded 4 times at a pressure of 10 cm water. Kaplan Meier method was used to evaluate the univariate relationship between risk factor and stent occlusion, and Cox regression survival analysis was used to evaluate the multivariate relationship between risk factor and stent occlusion. Results 64 patients with CP were included, with 43 males and 21 females, the mean age was 38 years （range, 4 - 80 years）. The stents had been placed for a mean of 263 days （ range 26- 759 days）. Average stent diameter was 8F （range, 5 - 10 F）. The overall occlusion rate was 67.5% （52/77）, the nonocclusion rates at 90, 180, 360, 540 d were 96. 1% （74/77）, 72.7% （56/77） ,58.4% （45/77） and 35.1% （27/77）. In the Cox regression analysis, endoprosthesis diameter ≥ 8.5F was shown to be the only risk factors for stent occlusion. Conclusions A significant proportion of stents placed after 180 d were not occluded, and were significantly lower than those reported from similar studies overseas. Pancreatic endoprosthesis diameter ≥8.5F was prone to occlusion.

关 键 词：胰腺炎 慢性 胰管 支架 回顾性研究 支架堵塞率 

分 类 号：R576[医药卫生—消化系统]