摘要
目的:通过分析气管插管全身麻醉下治疗性内镜逆行胰胆管造影术(therapeutic endoscopic retrograde cholangiopancreatography,tERCP)的安全性,探究此种手术患者术后不良事件发生的危险因素。方法:选取2020年1—12月因梗阻性黄疸而接受气管插管全身麻醉下tERCP的患者,收集患者的基本资料和术后住院期间发生的不良事件情况,通过单、多因素逻辑回归分析寻找气管插管全身麻醉下tERCP患者术后不良事件发生的危险因素。结果:共纳入70例因梗阻性黄疸而接受气管插管全身麻醉下tERCP的患者,其中58例(82.9%)患者的梗阻性黄疸由肿瘤原因引起,12例(17.1%)患者的梗阻性黄疸由胆总管结石引起。共有62例(88.6%)患者的tERCP成功完成,平均手术时间为19.9 min,术后平均住院时间为9 d。有8例患者术后出现不良事件,包括2例消化道出血,3例感染性休克,1例急性胰腺炎,1例消化道穿孔和1例肝肾综合征。多因素逻辑回归分析发现,患者术前白蛋白值低是气管插管全身麻醉下tERCP患者术后不良事件发生的独立危险因素(OR=0.768,P=0.042)。结论:气管插管全身麻醉下tERCP的安全性高,患者术前白蛋白值低是其术后不良事件发生的独立危险因素。
Objective:To evaluate the safety of therapeutic endoscopic retrograde cholangiopancreatography(tERCP)under general anesthesia with endotracheal intubation and explore the risk factor of postoperative adverse event.Methods:Patients with obstructive jaundice and undergoing general anesthesia with endotracheal intubation during tERCP from January 2020 to December 2020 were included.Baseline characteristics and postoperative adverse events were followed-up.Univariate and multivariate logistic regression analyses were used to identify risk factors of postoperative adverse events.Results:A total of 70 patients were included.The jaundice in 58(82.9%)patients were caused by malignant tumor,and 12(17.1%)patients by choledocholithiasis.Sixty-two(88.6%)patients successfully underwent tERCP with the median operative time of 19.9 min.The average postoperative hospitalized time was 9 days.Eight patients had adverse events after tERCP,including two with gastrointestinal bleeding,three with septic shock,one with acute pancreatitis,one with gastrointestinal perforation and one with hepatorenal syndrome.A multivariate logistic regression analysis showed that the low albumin level before tERCP was the independent risk factor for postoperative adverse event(OR=0.768,P=0.042).Conclusion:The tERCP under general anesthesia with endotracheal intubation is safety.The low albumin level before tERCP is the independent risk factor for postoperative adverse event.
作者
袁伟
王良刚
张振英
葛春林
张欣欣
YUAN Wei;WANG Lianggang;ZHANG zhenying;GE Chunlin;ZHANG Xinxin(Department of Anesthesiology,the Central Hospital of Xuhui District,Shanghai 200031,China)
出处
《上海医药》
CAS
2023年第9期11-14,19,共5页
Shanghai Medical & Pharmaceutical Journal
关键词
内镜逆行胰胆管造影术
全身麻醉
安全性
不良事件
endoscopic retrograde cholangiopancreatography
general anesthesia
safety
adverse event
