内镜逆行性胆管胰管造影术治疗老年胆管结石伴胆管炎患者复发影响因素

Influence of Retrograde Endoscopic Cholangiopancreatic Angiography on Recurrent Cholangiolithiasis in Elderly Patients with Cholangitis

目的:分析内镜逆行性胆管胰管造影术(ERCP)治疗老年胆管结石伴胆管炎患者复发影响因素。方法:选取2021年1月—2023年8月于毕节市第三人民医院行ERCP治疗的患者100例作为研究对象,在患者接受ERCP治疗后,对其进行随访,统计患者胆管炎复发情况,将患者分为复发组与未复发组。比较不同复发情况下患者的临床资料,分析老年胆管炎患者在接受ERCP治疗后胆管炎复发的影响因素。结果:在患者经过治疗后随访中,出现胆管炎复发50例(50.00%)。复发组手术时间长于未复发组,憩室发生率、血清总胆红素(TBil)水平、血清碱性磷酸酶(ALP)水平、血清空腹血糖(FBG)水平、血清C反应蛋白(CRP)水平高于未复发组,十二指肠镜重复消毒率低于未复发组,差异有统计学意义(P<0.05)。治疗后胆管炎复发多元回归因素进行分析,手术时间、憩室(合并=1,未合并=0)、血清TBil水平、血清ALP水平、血清FBG水平、血清CRP水平等因素影响患者复发,差异有统计学意义(P<0.05)。结论:ERCP治疗老年胆管结石伴胆管炎的效果良好,但是实际治疗会受到患者年龄因素的影响,手术时间、十二指肠镜未重复消毒、血清TBil、ALP、CRP、FBG水平高是治疗后胆管炎反复发作的主要因素。

Objective:To analyze the influential factors of endoscopic retrograde cholangiopancreatic angiography(ERCP)in the treatment of elderly patients with cholangitis.Methods:A total of one hundred patients who received ERCP treatment in Bijie Third People's Hospital from January 2021 to August 2023 were selected as the study objects.Patients were followed up after receiving ERCP.The recurrence of cholangitis was analyzed and the patients were divided into recurrence group and non-recurrence group.The clinical data of patients with different recurrence cases were compared to analyze the factors affecting the recurrence of cholan⁃gitis in elderly patients after ERCP treatment.Results:In the follow-up after treatment,50 patients(50.00%)had recurrent cholan⁃gitis;the operation time of recurrence group was longer than that of non-recurrence group,and the incidence of diverticula,serum total bilirubin(TBil)level,serum alkaline phosphatase(ALP)level,serum fasting blood glucose(FBG)level and serum C-reactive protein(CRP)level were higher than those of non-recurrence group,the repeated disinfection rate of duodenoscope was lower than that of non-recurrence group,and the difference was statistically significant(P<0.05);multiple regression factors for cholangitis re⁃currence after treatment were analyzed,operation time,diverticula(combined=1,uncombined=0),serum TBil level,serum ALP level,serum FBG level,serum CRP level and other factors affected patients'recurrence,and the differences were statistically sig⁃nificant(P<0.05).Conclusion:ERCP has a good effect on the treatment of elderly bile duct stones with cholangitis,but the actual treatment is affected by the age of the patient.The operation time,the non-repeated disinfection of duodenoscope,and the high lev⁃els of serum TBil,ALP,CRP and FBG are the main factors for the recurrence of cholangitis after treatment.