梗阻性黄疸患者经皮肝穿胆道引流术后胆道感染的分析

Biliary infection in patients with obstructive jaundice after percutaneous transhepatic biliary drainage

目的分析梗阻性黄疸患者经皮肝穿胆道引流术后胆道感染的相关因素,为临床降低感染率提供参考。方法选取2013年7月-2015年2月在医院行经皮肝穿胆道引流术的140例梗阻性黄疸患者临床资料,分析患者行经皮肝穿胆道引流术后发生胆道感染的易感因素,数据采用SPSS 17.0统计软件进行处理。结果 140例梗阻性黄疸患者行经皮肝穿胆道引流术后发生胆道感染36例,感染率25.71%;单因素分析显示,高位胆道梗阻、胆道再狭窄及胆道外引流管留置时间长的患者发生胆道感染率高,差异有统计学意义(P<0.05);logistic分析显示,梗阻的位置、胆管再狭窄以及外引流管的留置时间,是行经皮肝穿胆道引流术后胆道感染的危险因素。结论胆道感染为经皮肝穿胆道引流术后常见的并发症,属于内源性感染,及时采取有效预防措施及减少胆汁异常引流,保持胆道引流畅通,可降低经皮肝穿胆道引流术后感染的风险。

OBJECTIVE To analyze relevant factors causing postoperative biliary tract infection in obstructive jaundice patients after percutaneous transhepatic biliary drainage,in order to reduce incidence of clinical infection.METHODS From Jul.2013-Feb.2015,clinical data of 140 obstructive jaundice patients who underwent percutaneous transhepatic biliary drainage was collected.Predisposing factors for biliary tract infection in patients underwent percutaneous transhepatic biliary drainage were analyzed;data were dealt with SPSS 17.0statistically.RESULTS Among 140 obstructive jaundice patients underwent percutaneous transhepatic biliary drainage,there were 36 cases of biliary tract infection,and infection rate was 25.71%.Single factor analysis indicated that patients with upper biliary tract obstruction,biliary re-stricture and long retention time of had higher biliary tract infection.Difference was significant（P〈0.05）.According to logistic analysis,the location of obstruction,biliary restenosis,retention time of external drainage indwelling catheter were risk factors of postoperative biliary infection of percutaneous transhepatic biliary drainage.CONCLUSIONBiliary tract infection,belongsing to endogenous infection is a common complication after percutaneous transhepatic biliary drainage.It is suggested to take effective preventive measures,reduce abnormal bile drainage,and keep biliary drainage flow,so as to reduce risk factors of postoperative infection after percutaneous transhepatic biliary drainage.