摘要
目的探讨胆管扩张症患者在术后近期和远期发生胆道感染的相关因素。方法回顾性分析2012年5月至2020年10月北京协和医院收治并获得随访的121例胆管扩张症患者的临床资料。男性21例(17.4%),女性100例(82.6%),年龄(40.5±15.3)岁(范围:18~80岁)。将术后30 d内发生的胆道感染定义为近期感染,超过30 d发生的胆道感染定义为远期感染。通过单因素分析和Logistic回归分析筛选胆管扩张症术后发生近期和远期胆道感染的相关因素。结果121例胆管扩张症患者中,TodaniⅠ型85例(70.2%),Ⅲ型1例(0.8%),Ⅳ型32例(26.4%),Ⅴ型3例(2.5%)。随访时间(55.2±28.6)个月(范围:1~101个月)。分别有18例和37例患者发生术后近期和远期胆道感染。18例患者发生除胆道感染外的术后并发症,其中腹水6例,胆瘘4例,胰瘘和胃排空延迟各2例,胸腔积液、腹腔感染、伤口不愈合和胰腺炎各1例。单因素分析结果显示,术前胆道感染病史、是否行肝门部吻合和Todani分型是近期胆道感染的相关因素(P值均<0.05),术后并发症是远期胆道感染的相关因素(P<0.05)。Logistic回归分析结果显示,是否行肝门部吻合(OR=6.228,95%CI:1.884~20.586,P=0.003)和术前胆道感染病史(OR=3.701,95%CI:1.137~12.043,P=0.030)是近期胆道感染的独立相关因素;年龄是否≥45岁(OR=2.261,95%CI:1.004~5.093,P=0.049)和术后并发症(OR=3.131,95%CI:1.094~8.958,P=0.033)是远期胆道感染的独立相关因素。结论行肝门部吻合和术前有胆道感染病史与胆管扩张症术后发生近期胆道感染相关;年龄是否≥45岁和术后并发症与胆管扩张症术后发生远期胆道感染相关。
Objective To analyze the related factors of bile duct infection in patients with biliary dilatation in the short and long term after operation.Methods The data of the patients with biliary dilatation admitted at Peking Union Medical College Hospital between May 2012 and October 2020 were analyzed retrospectively.A total of 121 patients were enrolled in the study.There were 21 males(17.4%)and 100 females(82.6%),with age of(40.5±15.3)years(range:18 to 80 years).Short-term infection was defined as bile duct infection occured within 30 days after operation;long-term infection was defined as bile duct infection occured 30 days after operation The relationship between bile duct infection and clinicopathologic biliary dilatation features were analyzed using univariate and multivariate analyses.Results There were 85(70.2%),1(0.8%),32(26.4%)and 3(2.5%)patients with Todani typeⅠ,Ⅲ,ⅣandⅤ,respectively.The mean follow-up time was(55.2±28.6)months(range:1 to 101 months).There were 18 and 37 patients had short-term and long-term bile duct infection after surgery,respectively.Postoperative complications occurred in 18 patients and included ascites(n=6),biliary fistula(n=4),pancreatic fistula(n=2),gastroparesis(n=2),pleural effusion(n=1),abdominal infection(n=1),non-healing wound(n=1),and pancreatitis(n=1).Univariate analysis showed that preoperative history of bile duct infection,hilar anastomosis and Todani types were related factors for short-term bile duct infection,and postoperative complication was a related factor for long-term bile duct infection.Multivariate analysis showed that hilar anastomosis(OR=6.228,95%CI:1.884-20.586,P=0.003)and preoperative history of bile duct infection(OR=3.701,95%CI:1.137-12.043,P=0.030)were independent related factors for short-term bile duct infection after biliary dilatation operation,and age≥45 years(OR=2.261,95%CI:1.004-5.093,P=0.049)and postoperative complication(OR=3.131,95%CI:1.094-8.958,P=0.033)were independent related factors for long-term bile duct infection after biliar
作者
吴昕
李秉璐
郑朝纪
刘卫
洪涛
Wu Xin;Li Binglu;Zheng Chaoji;Liu Wei;Hong Tao(Department of General Surgery,Peking Union Medical College Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730,China)
出处
《中华外科杂志》
CAS
CSCD
北大核心
2021年第4期284-288,共5页
Chinese Journal of Surgery
基金
中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2019XK320012)。
关键词
胆道疾病
胆总管囊肿
胆管扩张症
胆道感染
Biliary tract diseases
Choledochal cyst
Biliary dilatation
Bile duct infection
