ERCP术后胆总管结石复发的危险因素分析  

Analysis of the risk factors of common bile duct stones recurrence after ERCP

作　　者：王梦洁 王启之[1] 燕善军[1] 郑海伦[1] 邓晓晶[1] 李大鹏[1] WANG Meng-jie;WANG Qi-zhi;YAN Shan-jun;ZHENG Hai-lun;DENG Xiao-jing;LI Da-peng(Department of Gastroenterology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院消化内科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2022年第5期589-593,共5页Journal of Bengbu Medical College

基　　金：安徽省自然科学基金项目(1808085MH240)。

摘　　要：目的:分析胆总管结石病人经内镜下逆行胰胆管造影术(ERCP)治疗后结石复发的相关危险因素。方法:将行ERCP取石术的256例胆总管结石病人纳入研究,随访6个月以上。将复发的17例作为复发组,其余239例作为非复发组,回顾性分析2组病人在一般情况、胆道情况、结石情况、实验室检查、手术方式等方面的差异。结果:2组病人在年龄、胆囊切除术史、胆总管直径、结石大小、结石数量方面差异均有统计学意义(P<0.05~P<0.01)。Logistic回归分析显示,有胆囊切除术史、最大结石直径越大、结石数量≥2是ERCP术后结石复发的独立危险因素(P<0.05~P<0.01)。结论:对于年龄大、有胆囊切除术史、胆总管直径较宽、结石直径大、数量多的病人一定要做好术前评估,术中规范,术后预防,加强随访来减少结石复发。Objective:To analyze the risk factors of stone recurrence in patients with common bile duct stone after endoscopic retrograde cholangiopancreatography(ERCP).Methods:A total of 256 patients with common bile duct stone treated with ERCP were selected,and all patients were followed up for more than 6 months.The 17 patients with recurrence and 239 patients without recurrence were divided into the recurrence group and non-recurrence group,respectively.The general conditions,biliary tract conditions,calculus conditions,laboratory tests and surgery method in two groups were retrospectively analyzed.Results:The differences of the age,history of cholecystectomy,diameter of common bile duct,stone size and number of stones between two groups were statistically significant(P<0.05 to P<0.01).The results of logistic regression analysis showed that the history of cholecystectomy,large stone diameter and stone number≥2 were the independent risk factors of stone recurrence after ERCP(P<0.05 to P<0.01).Conclusions:For patients with older age,history of cholecystectomy,wide diameter of common bile duct,large stone diameter and large number,the preoperative evaluation,intraoperative specification,postoperative prevention and enhanced follow-up must be done to reduce the recurrence of stones.

关 键 词：胆总管结石 内镜下逆行性胰胆管造影 复发 

分 类 号：R575.7[医药卫生—消化系统]