ERCP术后胰腺炎的影响因素分析

Analysis of the risk factors for post ERCP pancreatitis.

目的探讨诊断性与治疗性ERCP术后引发AP的高危因素及防范措施。方法采用单因素及多因素变量分析方法，对54例行诊断与治疗性ERCP的患者进行队列研究。结果54例患者中，3例（5，6％）并发ERCP术后胰腺炎（PEP），其中1例为诊断性ERCP，2例为诊疗性ERCP，ERCP术后胰腺炎均为轻症，经内科综合治疗后均痊愈出院。与PEP相关的主要因素有多次插管、多次胰管造影、导丝多次进入胰管、导丝引导插管、术中腹痛、全胰管显影、既往有胰腺炎病史等。其中，多次插管、胰管多次造影以及术中腹痛为高危因素。结论PEP与患者自身因素及医师操作技术有关，有效避免或减少这些高危因素的发生可预防PEP。

Objective To analyze the risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP）. Methods The risk factors for PEP were analyzed in 54 patients who received diagnostic or therapeutic ERCP by univariate and multivariate analysis. Results 3 patients （5. 6%） developed mild PEP, among which one patient received diagnostic ERCP, while 2 patients received therapeutic ERCP. Risk factors for PEP were multiple cannulation attempts, multiple pancreatic duct injections, multiple guide wire entry into pancreatic duct, cannulation by guide wire leading, abdominal pain during ERCP, visualization of whole pancreatic duct and history of PEP. High risk factors for PEP included multiple cannulation attempt, multiple pancreatic duct injections and abdominal pain during ERCP. Conclusions PEP is related to the characteristics of patients and the skills of the endoscopes.