胆管空肠Roux-en-y吻合术后逆行性胆管感染的相关临床因素分析

Analysis of clinical factor associated with retrograde infection of biliary tract after bile duct jejunum Roux-en-y anastomosis

目的探讨胆管空肠Roux-en-y吻合术后逆行性胆管感染的相关临床因素。方法选择本院收治并实施胆管空肠Roux-en-y吻合术患者134例,分析糖尿病病史(有或无)、吻合口直径(≤2 cm或>2 cm)、吻合方式(侧侧吻合、端侧吻合)、术前黄疸持续时间(≤7 d或>7 d)、术前胆红素水平(≤171μmol/L或>171μmol/L)、术中抗菌药物(有或无)对术后逆行性胆管感染的影响。结果合并糖尿病患者发生逆行性胆管感染发生率高于无糖尿病患者,差异有统计学意义(P<0.05);吻合口直径≤2 cm患者发生逆行性胆管感染发生率高于吻合口直径>2 cm患者,差异有统计学意义(P<0.05);侧侧吻合患者的逆行性胆管感染发生率高于端侧吻合患者,差异有统计学意义(P<0.05)。结论胆管空肠Roux-en-y吻合术后逆行性胆管感染与患者是否合并糖尿病、吻合口大小及吻合方式有关,值得临床借鉴。

Objective To explore the clinical factor associated with retrograde infection of biliary tract after bile duct jejunum Roux-en-y anastomosis. Methods 134 cases of patients with bile duct jejunum Roux-en-y anastomosis were selected.The history of diabetes（with or without）,stoma diameter（≤2 cm or〉2 cm）,anastomosis（side to side anastomosis or end to side anastomosis）preoperative duration of jaundice （≤7 d or〉7 d）,preoperative bilirubin levels （≤ 171 μmol/L or〉171μmol/L）,antibacterial drug operation （with or without） on the effect of retrograde biliary tract infection after operation was analyzed respectively. Results The incidence rate in retrograde infection of biliary tract patients with di-abetes was higher than that in patients without diabetes,with statistical difference （P〈0.05）.The incidence rate in retro-grade infection of biliary tract patients with anastomotic diameter≤ 2 cm was higher than that in patients with anasto-motic diameter〉2 cm,with statistical difference （P〈0.05）.The incidence rate in retrograde infection of biliary tract pa-tients with side to side anastomosis was higher than that in patients with end to side anastomosis,with statistical differ-ence（P〈0.05）. Conclusion The retrograde infection of biliary tract after bile duct jejunum Roux-en-y anastomosis is related with diabetes,stoma size and consistent style,and it is worthy of clinical reference.