摘要
目的构建内镜下逆行胰胆管造影(ERCP)术后患者并发胰腺炎的危险因素回归方程。方法对2020年1月至2022年12月山西省汾阳医院收治的ERCP术后患者1026例临床资料进行回顾性分析。根据ERCP术后患者并发胰腺炎情况分为胰腺炎组(n=105)和无胰腺炎组(n=921)。通过单因素及多因素Logistic回归分析法分析ERCP术后患者并发胰腺炎的危险因素,建立危险因素回归方程,并绘制受试者工作特征(ROC)曲线,分析危险因素回归方程对ERCP术后患者并发胰腺炎的预测价值。结果ERCP术后患者1026例,并发胰腺炎105例,胰腺炎发生率为10.23%。多因素Logistic回归分析结果显示,胰管插管、造影剂注射频次≥2次、既往存在胰腺炎史、括约肌功能障碍为ERCP术后患者并发胰腺炎的危险因素(OR值分别为3.334、8.560、3.818、2.449,均P<0.05)。构建危险因素回归方程:Logit(P)=-4.588+1.204×胰管插管+2.147×造影剂注射频次+1.340×既往存在胰腺炎史+0.596×括约肌功能障碍,ROC曲线下面积(AUC)为0.842,灵敏度为0.76、特异度为0.77。结论ERCP术后患者并发胰腺炎的风险较高,其发生与胰管插管、造影剂注射频次≥2次、既往存在胰腺炎史、括约肌功能障碍等因素密切相关,构建的危险因素回归方程对ERCP术后患者并发胰腺炎的危险因素具有良好的预测价值。
objective To establish risk factors regression equation for postoperative pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP).Methods The clinical data of 1026 patients with ERCP treated in Fenyang Hospital from Jan.2020 to Dec.2022 were retrospectively analyzed.According to the occurrence of postoperative pancreatitis,patients were divided into the pancreatitis group(n=105)and the non-pancreatitis group(n=921).The risk factors of postoperative pancreatitis after ERCP were analyzed by univariate and multivariate Logistic regression.The risk factor regression equation was established,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of risk factor regression equation for postoperative pancreatitis after ERCP.Results Among 1026 patients underwent ERCP,postoperative pancreatitis was found in 105 cases,the incidence rate was 10.23%.Multivariate Logistic regression analysis showed that pancreatic duct intubation,frequency of contrast medium injection≥2 times,history of pancreatitis,and sphincter dysfunction were risk factors for the occurrence of pancreatitis after ERCP(ORs were 3.334,8.560,3.818,2.449,respectively,all P<0.05).The regression equation of risk factors was established:Logit(P)=-4.588+1.204×pancreatic duct intubation+2.147×frequency of contrast medium injection+1.340×history of pancreatitis+0.596×sphincter dysfunction,the area under the ROC curve(AUC)was 0.842,the sensitivity was 0.76 and the specificity was 0.77.Conclusion Patients with ERCP have a high risk of developing postoperative pancreatitis,and the occurrence is closely related to pancreatic duct intubation,frequency of contrast medium injection≥2 times,previous history of pancreatitis,sphincter dysfunction,the regression equation has a good prediction value for the risk factors of developing pancreatitis after ERCP.
作者
王淑娟
陈军
张国峰
李慧波
王晓锐
闫海燕
WANG Shujuan;CHEN Jun;ZHANG Guofeng;LI Huibo;WANG Xiaorui;YAN Haiyan(Third Ward of General Department,Shanxi Fenyang Hospital,Lvliang,Shanxi 032200,China)
出处
《肝胆胰外科杂志》
CAS
2023年第10期595-601,共7页
Journal of Hepatopancreatobiliary Surgery
基金
山西省汾阳医院院级科研课题(202324)。
关键词
内镜下逆行胰胆管造影
胰腺炎
预测价值
危险因素
回归方程
endoscopic retrograde cholangiopancreatography
pancreatitis
predictive value
risk factors
regression equation
