胆道梗阻患者进行十二指肠镜逆行胰胆管造影术的感染因素分析

Incidence of infections in biliary obstruction patients after duodenal endoscopic retrograde cholangiopancreatography

目的:分析胆道梗阻患者进行十二指肠镜逆行胰胆管造影术感染的相关因素。方法:425例胆道梗阻患者均进行十二指肠镜逆行胰胆管造影术,比较患者的一般资料。结果:经由ERCP手术引发胆道感染61例,占14.4%,胰腺炎13例,占3.1%,上消化出血9例,占2.1%。高位胆道梗阻与低位胆道梗阻患者的胆道感染率分别为22.7%,2.9%;ERCP手术是否发生胆道感染与患者的年龄及性别无关(P>0.05);胆道感染的61例患者Ⅲ级评分8例,Ⅳ级评分38例,Ⅴ级评分15例;未出现胆道感染的364例患者:Ⅰ级评分42例,Ⅱ级评分98例,Ⅲ级评分119例,Ⅳ级评分56例,Ⅴ级评分49例,两组比较差异有统计学意义(P<0.05)。结论:胆道梗阻行十二指肠镜逆行胰胆管造影术引发胆道感染与患者的年龄、性别无关,高位胆道梗阻及ASA评分分级越高是引发胆道感染的危险因素。

Objective Analysis Incidence of infections in biliary obstruction patients after duodenal endoscopic retrograde cholangiopan-creatography. Method 425 patients with biliary obstruction underwent duodenal endoscopic retrograde cholangiopancreatography as re-search subjects,compared the patientˊs general information. Results Biliary tract infection caused by ERCp surgery was 61 cases （14. 4%）,pancreatitis was 13 cases（3. 1%）,upper gastrointestinal bleeding was 9 cases（2. 1%）,High biliary obstruction in patients with biliary obstruction biliary low infection rate was 22. 7%,2. 9%,respectively. Biliary tract infection with ERCp surgery was not associated with age and sex（P＆gt;0. 05）,III grade score was 8 cases,IV grade score was 38 cases,V grade score was 15 cases in 61 patients with Bili-ary tract infection after ERCp surgery,and I grade score was 42 cases,II grade score was 98 cases,III grade score was 119 cases,IV grade score was 56 cases,V was 49 cases in 364 patients without biliary tract infection after ERCp surgery,There was significant difference be-tween two groups（ P＆lt;0. 001 ）. Conclusion Biliary obstruction patients after duodenal endoscopic retrograde cholangiopancreatography is not associated with age and sex,AsA score and biliary obstruction are high risk factors of biliary tract infection after ERCp surgery.