ERCP术后胰腺炎的相关危险因素分析和探讨

Analysis of the Related Risk Factors of post-ERCP pancreatitis

目的探讨经内镜逆行胰胆管造影术(ERCP)后并发急性胰腺炎的危险因素。为预防ERCP术后急性胰腺炎(PEP)的发生提供依据参考。方法回顾性分析663例ERCP患者的临床资料,对各项研究指标进行Logistic回归分析。结果Logistic回归分析显示,女性、年龄>60岁、胰管显影、胰腺炎病史、操作时间、SOD、插管次数等7个因素与PEP的发生有相关性(P<0.05);而高血压、胆管扩张、糖尿病、黄疸与PEP的发生回归统计分析无明显差异性。结论合理的减少操作时间和插管次数,并对于可疑SOD患者放置鼻胆管或胰管引流,可以有效降低PEP的发生。

Objective To explore the risk factors of complicated pancreatitis after ERCP and to provide references to its prevention method. Methods The clinical data of 663 patients with ERCP were analyzed retrospectively. All indexes were analyzed by Logistic regression method. Results Logistic regression analysis showed that seven factors including female, age more than 60 years old,enhancement of the pancreatic duct, history of pancreatitis, operation time, SOD, intubation times were associated with the incidence of PEP（P〈0.05）; High blood pressure, bile duct expansion, jaundice had no relationship with the incidence of PEP. Conclusion Reasonable reducing operating time and the number of intubation, and placing nosal tube for bile duct or pancreatic duct for patients with suspected SOD, can effectively reduce the occurrence of PEP.