ERCP术后胰腺炎危险因素及鼻胆管引流的预防作用  

Risk Factors Resulting in Pancreatitis after ERCP and Preventive Effect of Nasobiliary Drainage

作　　者：王德承[1] 张海 石慧萍[1] 石海艳[1] 李丹[1] 熊莉[1] 

机构地区：[1]湖北省黄石市妇幼保健院儿科,黄石435000 [2]湖北理工学院附属医院 [3]黄石中心医院消化内科

出　　处：《数理医药学杂志》2015年第4期478-481,共4页Journal of Mathematical Medicine

基　　金：鼻胆管引流在内镜逆行胰胆管造影术后胰腺炎的临床研究(2012年度湖北省黄石市医药卫生科技攻关计划项目);项目编号:黄科技发农【2012】1号

摘　　要：目的:探究内镜逆行胰胆管造影术(ERCP)术后发生胰腺炎危险因素,并分析鼻胆管引流对预防胰腺炎的作用。方法:对黄石市中心医院收治的92例成功接受ERCP治疗的患者术后发生胰腺炎危险因素进行单因素、多因素分析,并随机分为两组,46例ERCP术后置入鼻胆管引流(实验组),46例ERCP术后未置入鼻胆管引流(对照组),对比两组术后胰腺炎发生率、血淀粉酶水平及症状体征。结果:12例(13.04%)患者ERCP术后发生胰腺炎,经单因素排除及多因素分析,女性、插管次数≥3次等是ERCP术后患者发生胰腺炎独立危险因素(P<0.05),而鼻胆管引流则是ERCP术后发生胰腺炎的保护因素(P<0.05)。实验组术后胰腺炎发生率及术后3h、12h、24h血淀粉酶水平等均显著低于对照组,且血清淀粉酶水平恢复正常时间、症状缓解时间及住院时间等均显著短于对照组,差异均有统计学意义(P<0.05)。结论:女性、插管次数≥3次是ERCP术后发生胰腺炎的危险因素,而鼻胆管引流可有效预防ERCP术后胰腺炎的发生。Objective:To explore the risk factors resulting in postoperative pancreatitis after endoscopic retrograde pancreatic angiography (ERCP) ,and analyse the role of nasobiliary drainage drainage in preven‐ting pancreatitis .Methods:Select 92 cases of patients received in central hospital of Huangshi city who were received ERCP successdully but were attacked by pancreatitis and make single factor analysis and multiple factor analysis on the postoperative factors resulting in their pancreatitis ,randomly divided into two groups , conduct nasobiliary drainage on 46 cases (experimental group) postoperatively ,w hile another 46 cases (con‐trol group) was not put into nasal biliary drainage postoperatively ,compared the occurance of postoperative pancreatitis ,the level of blood amylase ,symptoms and signs of the two groups .Results:12 cases (13 .04% ) were attacked by postoperative pancreatitis after ERCP ,based on single factor and multiple factor analysis , as for female ,it found that intubation times ≥ 3 were the independent risk factors for patients with ERCP postoperative pancreatitis (P< 0 .05) ,and the nasal biliary drainage was protective factor aganist ERCP postoperative pancreatitis (P<0 .05) .In experimental group ,the incidence of postoperative pancreatitis and postoperative level of blood amylase in the following 3 h ,12 h and 24 h after ERCP were significantly lower than that in control group ,and the duration for serum amylase level back to normal ,relieving duration of symptoms ,and length of hospital stay were significantly shorter than that in control group ,the differences were statistically significant (P<0 .05) .Conclusion:Female ,3 or more times of intubation is the risk factor for ERCP postoperative pancreatitis ,and nasal biliary drainage can effectively prevent the occurance of the ERCP postoperative pancreatitis .

关 键 词：胰腺炎 鼻胆管引流 内镜逆行胰胆管造影术 危险因素 

分 类 号：R657.51[医药卫生—外科学]