胰胆管造影术后发生胰腺炎的危险因素分析

Analysis of the Risk Factors for Pancreatitis after Cholangiopancreatography

目的:探讨经胰胆管造影术后患者发生胰腺炎的危险因素,以期为临床实践提供一定的参考依据。方法:回顾性分析2015年1月1日至2018年1月1日入住我院行胰胆管造影术的患者,根据纳入排除标准,分成胰腺炎组和非胰腺炎组,比较分析两组患者的性别、年龄、既往行内镜逆行性胰胆管造影术(endoscopic retrograde pancreatic cholangiography,ERCP)与否、ERCP次数、ERCP手术时间、胆道括约肌气囊扩张术、插管困难等因素和血清炎症因子TNF-α、IL-1、IL-6、IL-10的表达情况。结果:研究共纳入1891例患者,并发胰腺炎者124例(6.55%),非胰腺炎患者1767例。性别、年龄、既往行ERCP、ERCP次数、ERCP手术时间、胆道括约肌气囊扩张术、插管困难均为胰腺炎发生的危险因素,且ERCP手术时间和胆道括约肌气囊扩张术是为并发胰腺炎的独立危险因素。ERCP术后胰腺炎组血清TNF-α、IL-1、IL-6、IL-10的表达水平均显著高于非胰腺炎组(P<0.05)。结论:ERCP手术时间、胆道括约肌气囊扩张术及高血清炎症因子水平可能是并发胰腺炎的独立危险因素。

Objective:To investigate the risk factors of pancreatitis after pancreaticochotomy,and provide a reference for clinical practice.Methods:A retrospective analysis of patients who underwent cholangiopancreatography in our hospital from January 1,2015 to January 1,2018 was performed.According to the exclusion criteria,they were divided into the pancreatitis group and the non-pancreatitis group.Gender,age,previous endoscopic retrograde pancreatic cholangography(ERCP)or not,ERCP frequency,ERCP operation time,biliary sphincter balloon dilatation,intubation difficulties and other factors and serum TNF-α,IL-1,IL-6,IL-10 expression were analyzed.Results:A total of 1891 patients were enrolled,124(6.55%)cases with pancreatitis.Gender,age,previous ERCP,ERCP frequency,ERCP operation time,biliary sphincter balloon dilatation,and intubation difficulties are risk factors for pancreatitis,and ERCP surgery time and biliary sphincter balloon dilatation are independent of concurrent pancreatitis.The levels of serum TNF-α,IL-1,IL-6 and IL-10 in the pancreatitis group after ERCP were significantly higher than those in the non-pancreatitis group(P<0.05).Conclusion:The operation time,biliary sphincter balloon dilatation and high serum inflammatory factor levels may be independent risk factors for the pancreatitis after ERCP.