摘要
目的:研究经内镜逆行性胰胆管造影(ERCP)选择性插管困难的影响因素。方法:本研究纳入行ERCP的345例病人,其中40例选择性插管困难,设为观察组,其余305例病人设为对照组,调查2组病人憩室分布情况、ERCP指征以及年龄、性别等病例资料,组间先行单因素分析,差异有统计学意义的因素再纳入logistic回归分析,调查ERCP选择性插管困难的独立危险因素。结果:345例行ERCP病人选择性插管困难40例,插管困难率11.59%;观察组与对照组性别、年龄、急诊ERCP、ERCP指征差异均无统计学意义(P>0.05),观察组憩室分布、十二指肠乳头松弛且较长、胆总管弯曲成角、胆胰管汇合方式、乳头形态、胆总管下段狭窄差异均具有统计学意义(P<0.05~P<0.01);logistic回归分析显示,十二指肠乳头松弛且较长(OR=3.126)、胆总管弯曲成角(OR=2.811)、憩室内乳头(OR=2.703)、乳头中心非对称性憩室(OR=2.033)是ERCP选择性插管困难的独立危险因素(P<0.05)。结论:ERCP选择性插管困难出现率较高,十二指肠乳头松弛且较长、憩室分布、胆总管弯曲成角等解剖因素均会影响插管成功率。
Objective:To analyze the influencing factors of selective intubation difficulties in endoscopic retrograde cholangio-pancreatography(ERCP).Methods:A total of 345 patients treated with ERCP were investigated,and 40 cases with selective intubation difficulties and other 305 cases were divided into the observation group and control group,respectively.The data of diverticulum distribution,ERCP indications,age and gender between two groups were analyzed using the single factor method,and the differences of which with statistical significance were analyzed using logistic regression method.The independent risk factors of ERCP selective intubation difficulties were investigated.Results:Among 345 patients with ERCP,40 patients with selective intubation difficulties were identified,and the intubation difficulty rate of which was 11.59%.The differences of the gender,age,emergency ERCP and ERCP were not statistically significant between two groups(P>0.05),and the differences of the distribution of diverticulum,loose and long duodenal papilla,common bile duct bending angle,biliopancreatic duct confluence,nipple shape and stenosis of the lower segment of common bile duct were statistically significant between two groups(P<0.05 to P<0.01).The results of logistic regression analysis showed that the loose and long duodenal papilla(OR=3.126),common bile duct bending angle(OR=2.811),internal nipple of diverticula(OR=2.703)and asymmetric diverticula at the center of the nipple(OR=2.033)were the independent risk factors of ERCP selective intubation difficulties.Conclusions:The incidence rate of ERCP selective intubation difficulties is high,and the loose and long duodenal papilla,diverticulum distribution and common bile duct angle can affect the success rate of intubation.
作者
陈兆夷
刘有理
黄志刚
王光明
邓衍部
贺道兴
韩圆圆
CHEN Zhao-yi;LIU You-li;HUANG Zhi-gang;WANG Guang-ming;DENG Yan-bu;HE Dao-xing;HAN Yuan-yuan(Department of Gastroenterology,Xuancheng People′s Hospital,Xuancheng Anhui 242000,China)
出处
《蚌埠医学院学报》
CAS
2020年第8期1037-1040,共4页
Journal of Bengbu Medical College
基金
安徽省宣城市科技计划项目(201204)。
关键词
经内镜逆行性胰胆管造影
选择性插管困难
影响因素
endoscopic retrograde cholangio-pancreatography
selective intubation difficulty
influencing factor
