胆总管结石患者ERCP术后并发胆道出血的危险因素分析  

Analysis of Risk Factors for Postoperative Biliary Bleeding in Patients with Choledocholithiasis after ERCP

作　　者：汪西江 吴春城[2] 李文贞 无 WANG Xijiang;WU Chuncheng;LI Wenzhen;无(Department of Internal Medicine,Lushan People’s Hospital,Lushan 332800,China;Department of Gastroenterology,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330000,China;Department of Endoscopy,Lushan People’s Hospital,Lushan 332800,China)

机构地区：[1]江西省庐山市人民医院内四科,江西庐山332800 [2]江西中医药大学附属医院消化科,江西南昌330000 [3]江西省庐山市人民医院内镜室,江西庐山332800

出　　处：《中国伤残医学》2024年第23期54-56,60,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:分析胆总管结石患者内镜逆行胰胆管造影术(ERCP)术后并发胆道出血的危险因素。方法:回顾性分析2020年7月—2023年12月庐山市人民医院、江西中医药大学附属医院收治的80例胆总管结石行ERCP术患者临床资料,根据ERCP术后是否并发胆道出血分为出血组(n=20)和非出血组(n=60)。收集两组一般资料,以一般资料作为研究因素进行单因素分析,并对有统计学差异的因素进行多因素Logistic回归分析。结果:80例胆总管结石行ERCP术患者中,胆道出血发生率为25.00%(20/80)。相较于非出血组,出血组结石直径较长,且合并急性胆源性胰腺炎、术前有胆道感染、壶腹部嵌顿结石、十二指肠周围有憩室发生率均较高,差异均有统计学意义(P<0.05)。Logistic回归分析,结石直径长、合并急性胆源性胰腺炎、术前有胆道感染、壶腹部嵌顿结石、十二指肠周围憩室是影响胆管结石行ERCP术患者并发胆道出血的独立危险因素(P<0.05且OR>1)。结论:胆总管结石行ERCP术患者并发胆道出血与结石直径长、合并急性胆源性胰腺炎、有胆道感染、壶腹部嵌顿结石、十二指肠周围憩室有关。Objective:To analyze the risk factors of biliary bleeding after endoscopic retrograde cholangio pancreatography(ERCP)in patients with choledocholithiasis.Methods:Clinical data of 80 patients with common choledocholithocalculus undergoing ERCP were retrospectively analyzed from Lushan People’s Hospital and the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from July 2020 to December 2023,and were divided into a bleeding group(n=20)and a non-bleeding group(n=60)according to whether there was biliary bleeding after ERCP.The two groups of general data were collected,and the general data was used as the research factor for univariate analysis,and the factors with statistical differences were analyzed by multivariate Logistic regression.Results:The incidence of biliary tract hemorrhage was 25.00%(20/80)in 80 patients with choledocholitis undergoing ERCP.Compared with the non-bleeding group,the bleeding group had longer stone diameter,higher incidence of acute biliary pancreatitis,preoperative biliary tract infection,embedded stones in the ampulla,and diverticula around the 12th rectum,with statistical significance(P<0.05).Logistic regression analysis showed that length of stone diameter,acute biliary pancreatitis,preoperative biliary tract infection,ampulla embedding stones,and twelve perirectal diverticulum were independent risk factors for biliary tract hemorrhage in patients with biliary tract stones undergoing ERCP(P<0.05 and OR>1).Conclusion:The complications of biliary tract hemorrhage in patients with choledocholithiasis undergoing ERCP are related to the length of stone diameter,acute biliary pancreatitis,biliary tract infection,imbedded stones in the ampulla,and twelve perirectal diverticulum.

关 键 词：胆总管结石 内镜逆行胰胆管造影术 胆道出血 危险因素 

分 类 号：R575[医药卫生—消化系统]