内镜下逆行胰胆管造影术后引发胰腺炎的危险因素分析

Analysis of the Risk Factors of Pancreatitis after Endoscopic Retrograde Cholangiopancreatography

目的明确内镜下逆行胰胆管造影(ERCP)术后诱发胰腺炎的危险因素。方法回顾性分析2015年10月-2018年10月于南阳医学高等专科学校第一附属医院行治疗性ERCP的221例患者的临床资料,通过单因素及多因素分析确定术后胰腺炎发生的独立危险因素。结果单因素分析显示患者年龄≤50岁、胆总管直径≤10mm、多次插管及胰管显影和ERCP术后胰腺炎的发生存在相关性,差异有统计学意义(P<0.05);多因素Logistic分析显示胆总管直径≤10mm(P=0.001,OR=9.275)、多次插管(P=0.026,OR=3.677)、胰管显影(P=0.009,OR=5.912)是诱发ERCP术后胰腺炎的独立危险因素。结论胰腺炎是ERCP术后常见的并发症,胆总管直径≤10mm、多次插管及胰管显影是其发生的独立危险因素。对于具有这些危险因素的患者应采取有效的干预措施,以降低术后胰腺炎的发生率。

Objective To detect risk factors of pancreatitis for post-endoscopic retrograde cholangiopancreatography(ERCP).Methods The clinical data of 221 patients with therapeutic ERCP in our hospital from October 2015 to October 2018 were retrospective analyzed.Univariate and multivariate logistic regression analysis were performed on the basis of the above data.Results Univariate logistic regression showed that with age no more than 50 years old,common bile duct diameter no more than 10millimeter,multiple intubation,pancreatic ducts imaging,correlated with the occurrence of acute pancreatitis after ERCP(P<0.05);Multivariate Logistic regression analysis showed that common bile duct diameter no more than 10millimeter(P=0.001,OR=9.275),multiple intubation(P=0.026,OR=3.677),pancreatic duct imaging(P=0.009,OR=5.912)were independent risk factors of acute pancreatitis after ERCP.Conclusions Pancreatitis is the most frequent and devastating complication after ERCP,narrower common bile duct,multiple intubation,pancreatic duct imaging are independent risk factors for the occurrence of Pancreatitis.Patients with these risk factors need take preventive measures to decrease the incidence of pancreatitis after operation.