恶性胆管梗阻患者经皮肝穿刺胆道支架置入术后发生早期胆系感染的危险因素分析  

Risk factors for early biliary infection after implantation of percutaneous transhepatic biliary stent in patients with malignant biliary obstruction

作　　者：谭芬[1] 柳凤玲 何利贤 TAN Fen;LIU Feng-ling;HE Li-xian(Department of Surgery,Dazhou Central Hospital,Dazhou 635000,China;Department of Nursing,Dazhou Central Hospital,Dazhou 635000,China)

机构地区：[1]四川省达州市中心医院外科,四川达州635000 [2]四川省达州市中心医院护理部,四川达州635000

出　　处：《实用医院临床杂志》2020年第4期231-234,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析恶性胆管梗阻患者经皮肝穿刺胆道支架置入术后发生早期胆系感染的危险因素。方法2017年1月至2018年12月在我院接受经皮肝穿刺胆道支架置入术的137例恶性胆管梗阻患者,按术后是否发生早期胆系感染分为感染组(n=25)与非感染组(n=112)。采集两组一般临床资料、术前实验室指标、梗阻情况、支架置入及围术期用药等情况进行分析,明确恶性胆管梗阻患者经皮肝穿刺胆道支架置入术后发生早期胆系感染的危险因素。结果单因素分析显示两组在性别、年龄、术前疼痛、肿瘤类型分布、实验室指标、支架特征、支架类型、术后功能状态评分(PS)、围术期用药、术前经皮肝胆管引流术(PTCD)、术中使用球囊等因素上比较差异无统计学意义(P>0.05),但感染组中合并糖尿病、胆结石、高危梗阻、支架远端超过十二指肠乳头患者所占比重及术前功能状态评分(PS)、梗阻长度均显著高于非感染组(P<0.05);多因素Logistic回归分析,显示,糖尿病、高位梗阻、术前PS评分、梗阻长度均是恶性胆管梗阻患者经皮肝穿刺胆道支架置入术后发生早期胆系感染的独立危险因素。结论临床对恶性胆管梗阻患者开展经皮肝穿刺胆道支架置入术时,需对合并上述危险因素患者予以高度重视,尽可能降低术后发生早期胆系感染的风险。Objective To analyze the risk factors for early biliary infection after implantation of percutaneous transhepatic biliary stent in patients with malignant biliary obstruction.Methods One hundred and thirty-seven patients with malignant biliary obstruction who underwent implantation of percutaneous transhepatic biliary stent in our hospital from January 2017 to December 2018 were selected as study subjects.The patients were divided into infection group(n=25)and non-infection groups(n=112)according to whether early biliary infection occurred or not.Univariate analysis was performed on the general clinical data,preoperative laboratory parameters,obstruction,stent implantation and perioperative medication in the two groups.The items were analyzed to confirm the risk factors for early biliary infection after implantation of percutaneous transhepatic biliary stent in patients with malignant biliary obstruction.Results Univariate analysis showed there were no significant differences in the gender,age,preoperative pain,tumor type distribution,laboratory parameters,stent characteristics,stent types,postoperative PS score,perioperative medication,preoperative percutaneous transhepatic cholangial drainage(PTCD)and intraoperative use of balloon(P>0.05),but the proportions of patients with diabetes mellitus,gallstones,high-risk obstruction and distal end of stent exceeding duodenal papilla and preoperative functional status score(PS)and obstruction length in infection group were significantly higher than those in the non-infection group(P<0.05).Multivariate logistic regression analysis was performed by taking items with differences in the univariate analysis as covariates and early biliary infection occurrence as a dependent variable,and the results showed that diabetes mellitus,high obstruction,preoperative PS score and obstruction length were independent risk factors for early biliary infection after implantation of percutaneous transhepatic biliary stent in patients with malignant biliary obstruction.Conclusion In patients

关 键 词：恶性胆管梗阻 经皮肝穿刺胆道支架置入 早期胆系感染 危险因素 

分 类 号：R730.5[医药卫生—肿瘤]