内镜下逆行胰胆管造影术后非胰腺炎腹痛的危险因素

Risk Factors for Non-Pancreatitis Abdominal Pain after Endoscopic Retrograde Cholangiopancreatography

目的观察内镜下逆行胰胆管造影术(ERCP)后非胰腺炎腹痛发生情况,并分析其危险因素。方法回顾性分析2019年1月至2023年3月于南京鼓楼医院集团宿迁医院接受ERCP治疗的586例患者的临床资料,统计术后非胰腺炎腹痛发生率,并采用单因素和多因素Logistic回归分析影响ERCP后非胰腺炎腹痛发生的危险因素。结果586例ERCP后患者中,发生胰腺炎39例(6.66%)、非胰腺炎腹痛52例(8.87%)。52例非胰腺炎腹痛患者中,胆管炎17例(32.69%)、非特异性腹痛35例(67.31%)。单因素分析结果显示,女性、年龄<60岁、初次行ERCP、合并高血压、胰腺导丝通道、胆道支架置入、血红蛋白(Hb)≤120 g/L、丙氨酸转氨酶(ALT)<40 U/L、γ-谷氨酰转移酶(GGT)>35 U/L、直接胆红素(DBIL)>10μmol/L、总胆红素(TBIL)<28μmol/L、碱性磷酸酶(ALP)<185 U/L是ERCP术后发生非胰腺炎腹痛的危险因素(P<0.05)。多因素Logistic回归分析结果显示,女性(OR=2.277)、初次行ERCP(OR=4.019)、GGT>35 U/L(OR=2.838)、DBIL>10μmol/L(OR=3.504)是造成ERCP后非胰腺炎腹痛的独立危险因素(P<0.05)。结论女性、初次行ERCP及GGT和DBIL水平升高均为ERCP后发生非胰腺炎腹痛的独立危险因素。

Objective To observe the occurrence of non-pancreatitis abdominal pain after endoscopic retrograde cholangiopancreatography(ERCP)and analyze its risk factors.Methods With a retrospective analysis of clinical data from 586 patients who received ERCP treatment at Suqian Hospital of Nanjing Gulou Hospital Group from January 2019 to March 2023,the incidence of postoperative non-pancreatitis abdominal pain was statistically analyzed,and univariate and multivariate Logistic regression were used to analyze the risk factors affecting the occurrence of non-pancreatitis abdominal pain after ERCP surgery.Results Among 586 patients after ERCP,39 cases(6.66%)experienced pancreatitis and 52 cases(8.87%)experienced non pancreatitis abdominal pain.Among 52 patients with non pancreatitis abdominal pain,there were 17 cases of cholangitis(32.69%)and 35 cases of nonspecific abdominal pain(67.31%).The results of univariate analysis showed that female,age<60 years,first-time ERCP surgery,combined hypertension,pancreatic wire channel,biliary stent implantation,hemoglobin(Hb)≤120 g/L,alanine aminotransferase(ALT)<40 U/L,γ-glutamyltransferase(GGT)>35 U/L,direct bilirubin(DBIL)>10μmol/L,total bilirubin(TBIL)<28μmol/L and alkaline phosphatase(ALP)<185 U/L were the risk factors for non-pancreatitis abdominal pain after ERCP surgery(P<0.05).The results of multivariate Logistic regression analysis showed that female(OR=2.277),first-time ERCP(OR=4.019),GGT>35 U/L(OR=2.838),and DBIL>10μMol/L(OR=3.504)were independent risk factors for non-pancreatitis abdominal pain after ERCP surgery(P<0.05).Conclusion The female,first-time ERCP and GGT,and elevated DBIL levels were independent risk factors for non-pancreatitis abdominal pain after ERCP.