摘要
目的:探究胆总管结石患者腹腔镜切开取石后发生胆道并发症的影响因素。方法:回顾性选取2020年1月—2022年1月抚州市第一人民医院收治的82例胆总管结石患者为研究对象,根据患者行腹腔镜切开取石后是否发生胆道并发症分为并发组和未并发组,对比两组的临床资料,采用单因素及多因素logistic回归分析影响两组术后发生胆道并发症的相关因素。结果:82例胆总管结石患者行腹腔镜切开取石后,11例发生胆道并发症,71例未发生胆道并发症,术后胆道并发症发生率为13.41%(11/82);单因素分析结果提示,并发组年龄≥60岁、有胆道手术史、结石数量≥2个、有胆汁浑浊比例均高于未并发组,T管留置时间长于未并发组,血清白蛋白水平低于未并发组,差异均有统计学意义(P<0.05)。进一步多因素logistic回归分析结果提示,胆道手术史[OR=12.699,95%CI(1.195,134.973),P=0.035]、胆汁浑浊[OR=18.506,95%CI(1.675,204.430),P=0.017]均是影响患者腹腔镜切开取石后发生胆道并发症的独立危险因素,血清白蛋白水平[OR=0.795,95%CI(0.636,0.995),P=0.045]是其保护因素。结论:胆道手术史、胆汁浑浊均是影响患者行腹腔镜切开取石后发生胆道并发症的独立危险因素,患者术前血清白蛋白水平是其保护因素,临床上应尽早制订相应的针对性干预方案以避免或减少上述危险因素对临床疗效造成的不良影响。
Objective:To explore the influencing factors of biliary complications in patients with choledocholithiasis after laparoscopic lithotomy.Method:A total of 82 patients with choledocholithiasis admitted to the First People's Hospital of Fuzhou from January 2020 to January 2022 were retrospectively selected as the study object.The patients were divided into the concurrent group and the non-concurrent group according to the occurrence of biliary tract complications after laparoscopic lithotomy.The clinical data of the two groups were compared.Univariate and multivariate logistic regression were used to analyze the related factors affecting postoperative biliary tract complications in the two groups.Result:Of 82 patients with choledocholithiasis who underwent laparoscopic lithotomy,11 patients occurred biliary tract complications,71 patients did not occur biliary tract complications,and the incidence of postoperative biliary tract complications was 13.41%(11/82).Univariate analysis indicated that proportions of age≥60 years old,history of biliary tract surgery,number of stones≥2,bile turbidity were higher than those in the non-concurrent group,T-tube retention time was longer than that in the non-concurrent group,serum albumin level was lower than that in the non-concurrent group,the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis indicated that the history of biliary tract surgery[OR=12.699,95%CI(1.195,134.973),P=0.035],bile turbidity[OR=18.506,95%CI(1.675,204.430),P=0.017]were independent risk factors for biliary complications after laparoscopic lithotomy,and serum albumin level[OR=0.795,95%CI(0.636,0.995),P=0.045]was a protective factor.Conclusion:History of biliary tract surgery and bile turbidity are independent risk factors for biliary tract complications after laparoscopic lithotomy,and the preoperative serum albumin level of patients is a protective factor.In clinical practice,appropriate intervention programs should be developed as soon as possibl
作者
聂乐乐
NIE Lele(The First People's Hospital of Fuzhou,Jiangxi Province,Fuzhou 344100,China)
出处
《中国医学创新》
CAS
2023年第22期152-155,共4页
Medical Innovation of China
基金
抚州市社会发展指导性科技计划项目(结字【2022】第106号)。
关键词
胆总管结石
腹腔镜取石
胆道并发症
影响因素
Choledocholithiasis
Laparoscopic lithotomy
Biliary complications
Influencing factors
