摘要
目的分析肝硬化患者内镜逆行性胰胆管造影术后并发症的影响因素,旨在为未来肝硬化逆行性胰胆管造影术后并发症的防治提供指导。方法回顾性分析2016年1月至2019年3月期间中国人民解放军联勤保障部队第904医院接受内镜逆行性胰胆管造影术治疗的96例肝硬化患者临床资料,依据术后有无发生并发症将患者分为并发症组与无并发症组,经单因素与多因素分析可能导致肝硬化内镜逆行性胰胆管造影术后并发症发生的影响因素。结果本研究共纳入96例患者,术后发生并发症18例,发生率为18.75%;经初步单因素分析发现,食管静脉曲张、腹水、奧狄括约肌功能障碍(SOD)病史、反复插管、胰管造影、预切开均可能是肝硬化患者内镜逆行性胰胆管造影术后并发症发生的影响因素(P<0.05);对单因素初步证实的结果赋值后,经Logistic回归分析结果显示,食管静脉曲张、腹水、有SOD病史、反复插管、胰管造影、预切开均是肝硬化患者内镜逆行性胰胆管造影术后并发症发生的影响因素(OR>1,P<0.05)。结论食管静脉曲张、腹水、SOD病史、反复插管、胰管造影、预切开等均会提高肝硬化患者内镜逆行性胰胆管造影术后并发症发生风险,对于存在这些影响因素的患者,临床应积极给予合理干预,以降低预后风险。
Objective To analyze the risk factors of post-operative complications in patients with liver cirrhosis after endoscopic retrograde cholangiopancreatography(ERCP),and to provide guidance for the prevention of these complications.Methods The clinical data of 96 cases of liver cirrhotic patients that had received ERCP were retrospectively analyzed.The patients were divided into with complication group and without complication group according to whether they presented postoperative complications.Single and multi-factor analysis were performed in the cirrhotic patients to identify the risk factors for post-operative complications after ERCP treatment.Results Within the 96 cirrhotic patients that had received ERCP,18 patients(18.75%)presented postoperative complications.The preliminary single-factor analysis showed that esophageal varices, ascites, history of sphincter of Oddi dysfunction(SOD), repeated intubation,cholangiopancreatography,and pre-cut were the risk factors of post-operative complications after ERCP(P<0.05).The result of Logistic regression analysis showed that esophageal varices,ascites,history of SOD,repeated intubation,cholangiopancreatography,and pre-cut were the risk factors of developing complications after ERCP in the patients with liver cirrhosis(OR>1,P <0.05).Conclusion Esophageal varices,ascites,history of SOD,repeated intubation,cholangiopancreatography,and pre-cut increase the risk of complications of ERCP in liver cirrhotic patients.Patients with these risk factors should therefore obtain active intervention to improve the prognosis after ERCP.
作者
陈旭峰
许亚凤
周志华
向正国
汤小龙
杨胜兰
郑扬
CHEN Xu-feng;XU Ya-feng;ZHOU Zhi-hua;XIANG Zheng-guo;TANG Xiaolong;YANG Sheng-lan;ZHENG Yang(Department of Digestive System,Qiseases,904h Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Jiangsu,Wuxi 214044,China;Department of Hematology Oncology,904h Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Jiangsu,Wuxi 214044,China;Department of Pathology,904h Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Jiangsu,Wuxi 214044,China)
出处
《肝脏》
2021年第3期259-261,265,共4页
Chinese Hepatology
基金
无锡市科技发展医疗卫生项目(NZ2019029)。
关键词
肝硬化
内镜逆行性胰胆管造影术
并发症
影响因素
Liver cirrhosis
Endoscopic retrograde cholangiopancreatography
Complications
Risk factors
