摘要
目的探讨急性梗阻性化脓性胆管炎(acute obstructive suppurative cholangitis,AOSC)患者经皮肝穿刺胆道引流术后死亡的影响因素。方法回顾性分析首都医科大学附属北京友谊医院2015年1月至2019年7月收治的206例AOSC患者的临床资料,所有患者均接受经皮肝穿刺胆道引流术治疗,采用二元多因素Logistic回归分析探讨AOSC患者经皮肝穿刺胆道引流术后死亡的相关影响因素。结果206例患者中,死亡18例,死亡率为8.74%。二元多因素Logistic回归分析结果显示,年龄>60岁、发病至手术时间>5 d、术后24 h胆汁引流量<300 ml、入院时伴有休克、肾功能损伤均为AOSC患者经皮肝穿刺胆道引流术后死亡的独立危险因素(均P<0.05)。结论高龄、术后24 h胆汁引流量过少、入院时伴有休克和肾功能损伤均为AOSC患者经皮肝穿刺胆道引流术后死亡的独立危险因素,早期诊断和治疗,及时抗休克、术后及时复查对AOSC患者预后至关重要。
Objective To investigate the influencing factors of death in patients with acute obstructive suppurative cholangitis(AOSC)after percutaneous transhepatic cholangial drainage(PTCD).Method The clinical data of 206 AOSC patients admitted to Beijing Friendship Hospital,Capital Medical University from January 2015 to July 2019 were retrospectively analyzed.All patients received PTCD treatment.Binary multivariate Logistic regression analysis was used to explore the influencing factors for death in AOSC patients after PTCD.Result Of the 206 patients,there were 18 deaths,with a mortality rate of 8.74%.The results of binary multivariate Logistic regression analysis showed that patients aged>60 years,the time from onset to surgery>5 days,the bile drainage volume<300 ml at 24 h after surgery,shock upon admission,and renal impairment were all independent risk factors for death in AOSC patients after PTCD(all P<0.05).Conclusion Elderly patients,low bile drainage volume at 24 h after operation,shock and renal function injury at admission are independent risk factors for death in AOSC patients after PTCD.Early diagnosis and treatment,timely anti-shock and timely postoperative reexamination are crucial to prognosis of AOSC patients.
作者
徐彩云
卢俊红
王红银
Xu Caiyun;Lu Junhong;Wang Hongyin(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中国医学前沿杂志（电子版）》
2020年第3期142-145,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
经皮肝穿刺胆道引流
急性梗阻性化脓性胆管炎
预后
死亡
影响因素
Percutaneous transhepatic cholangial drainage
Acute obstructive suppurative cholangitis
Prognosis
Death
Influencing factors
