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作 者:叶靳华[1] 陆一凡[1] 孙长杰 李成[2] 李能平[3] 赵良超[1] 张家强[4] YE Jin-hua;LU Yi-fan;SUN Chang-jie;LI Cheng;LI Neng-ping;ZHAO Liang-chao;ZHANG Jia-qiang(Department of General Surgery,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,201801,China;Department of Ultrasound,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,201801,China;Department of Emergency,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,201801,China;Department of Pancreatic Surgery,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,201801,China)
机构地区:[1]上海交通大学医学院附属瑞金医院普外科,上海201801 [2]上海交通大学医学院附属瑞金医院超声科,上海201801 [3]上海交通大学医学院附属瑞金医院急诊科,上海201801 [4]上海交通大学医学院附属瑞金医院胰腺外科,上海201801
出 处:《现代生物医学进展》2022年第4期647-650,共4页Progress in Modern Biomedicine
基 金:国家自然科学基金项目(8180101219)。
摘 要:目的:探讨恶性梗阻性黄疸患者接受减黄治疗后早期胆管炎的相关因素。方法:回顾性分析自2013年1月至2020年7月上海瑞金医院北部院区普外科收治的恶性梗阻性黄疸患者的临床资料,根据减黄治疗后2周内是否发生胆管炎分为早期胆管炎组与非早期胆管炎,采用SPSS 21.0统计软件进行数据分析处理。结果:共入组69例临床资料,男性40例,女性29例,减黄治疗后早期发生胆管炎者17例,中位时间3(2,11.5)天。两组患者在年龄、性别、病程、总胆红素、引流方式上未发现统计学差异,而引流物直径、胆道梗阻部位存在统计学差异(P<0.05),进一步Logistic回归分析提示引流物直径是减黄治疗后发生早期胆管炎的相关因素[OR=0.889,95%CI(0.792,0.998),P=0.046]。结论:恶性梗阻性黄疸行减黄治疗时,应选择直径较大的引流物,对胆道进行充分、有效的引流,可减少减黄治疗后早期胆管炎的发生。Objective:To investigate the related factors of early cholangitis after biliary drainage for malignant obstructive jaundice.Methods:The clinical data of patients with malignant obstructive jaundice,from January 2013 to July 2020,treated in Department of General Surgery,Ruijin Hospital North,Shanghai JiaoTong University School of Medicine were analyzed retrospectively.According to cholangitis in two weeks after biliary drainage,the patients were divided into two groups.The clinical characteristics were analyzed by SPSS 21.0.Results:A total of 69 patients were enrolled in this study,including 40 males and 29 females.17 patients developed cholangitis within 2 weeks after biliary drainage,with a median infection time of 3(2-11.5 days).There were no significant differences in age,gender,course of disease,total bilirubin and drainage mode between the two groups,but there were significant differences in the diameter of drainage and the location of biliary obstruction(P<0.05).Logistic regression analysis showed that the diameter of drainage was the related factor of early cholangitis after biliary drainage[OR=0.889,95%CI(0.792,0.998),P=0.046].Conclusion:When malignant obstructive jaundice is treated by biliary drainage,large diameter drainage should be selected.It can reduce the occurrence of early cholangitis after biliary drainage for malignant obstructive jaundice by adequate and effective drainage of biliary.
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