胆管空肠Roux-en-y吻合术后逆行性胆道感染临床诊治及相关因素分析  

Clinical Diagnosis and Treatment of Retrograde Biliary Tract Infection after Bile Duct Jejunum Roux- en- y Anastomosis and Analysis of the Related Risky Factors

作　　者：何新卫[1] 赵辉[1] 文军[1] 陈少逸[1] 刘兴木[1] 

机构地区：[1]汕头大学医学院第二附属医院普外科,广东汕头505041

出　　处：《辽宁医学院学报》2016年第1期55-57,共3页Journal of Liaoning Medical University (LNMU) Bimonthly

摘　　要：目的探讨胆管空肠Roux-en-y吻合术后逆行性胆道感染临床诊治对策,对其感染发生的相关危险因素进行分析。方法对2013年2月至2015年2月在我院行胆管空肠Roux-en-y吻合术的患者143例的病史资料进行回顾性分析,采用Logistic回归分析对患者术后逆行性胆道感染的相关危险因素进行分析。结果胆管空肠Roux-en-y吻合术后逆行性胆道感染发生率为24.5%。35例患者中30例行积极的抗感染治疗后痊愈,5例由于病情较重再次行胆道手术,术后恢复良好。logistic多因素回归分析发现,吻合口直径≤2 cm、侧侧吻合以及合并糖尿病是胆管空肠Roux-en-y吻合术后逆行性胆道感染的独立危险因素(P<0.05)。结论吻合口直径、吻合方式及糖尿病史是胆管空肠Roux-en-y吻合术后发生逆行性胆道感染的相关因素,临床上需密切关注高危患者,及时有效的抗感染治疗可有效缓解疾病。Objective To investigate the clinical diagnosis and treatment of retrograde biliary tract infection after bite ducts jeju- num Roux - en - y anastomosis, and analyze the related risky factors of the infection. Methods The medical history data of 143 cases of patients with bile duct jejunum Roux - en - y anastomosis operated in our hospital from February 2015 to February 2013 were retro- spectively analyzed and the related risky factors of retrograde biliary tract infection after operation were analyzed by Logistic regression anlysis. Results The incidence of retrograde biliary tract infection after Roux - en - y anastomosis was 24. 5%. Of 35 patients, 30 cases were cured after the active anti - infective therapy, and 5 patients were operated again due to the more serious condition of biliary tract but the recovery was satisfactory. Multivariate logistic regression analysis showed that the hole of anastomosis operation was less than or equal to 2 cm and that side - to - side anastomosis operation and combined diabetes were the independent risky factors of retro- grade biliary tract infection after bile duct jejunum Roux - en - y anastomosis （P 〈 0. 05）. Conclusions The diameter of the anans- tomosis hole, the way of anastomosis and the history of diabetes are the related factors of retrograde biliary tract infection after bile duct jejunum Roux - en - y anastomosis. Clinically, close attention should be drawn to high - risk patients, and timely effective anti - in- fective therapy can effectively relieve the disease.

关 键 词：胆管空肠ROUX-EN-Y吻合术 胆道感染 危险因素 

分 类 号：R657.4[医药卫生—外科学]