本文關(guān)鍵詞： 膽總管結(jié)石 ERCP 急性胰腺炎 危險(xiǎn)因素 Logistic回歸分析　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:探討治療性ERCP術(shù)后發(fā)生急性胰腺炎的相關(guān)危險(xiǎn)因素,為預(yù)防術(shù)后急性胰腺炎的發(fā)生提供依據(jù)。方法:回顧性分析2014年5月至2016年6月廣西醫(yī)科大學(xué)第一附屬醫(yī)院消化內(nèi)科和普通外科共282例膽總管結(jié)石患者行ERCP治療的臨床資料。收集患者自身相關(guān)因素和術(shù)中操作相關(guān)因素,采用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行單因素χ2檢驗(yàn)和多因素logistic回歸分析,篩選出治療性ERCP術(shù)后發(fā)生急性胰腺炎的獨(dú)立危險(xiǎn)因素。結(jié)果:282例膽總管結(jié)石患者ERCP術(shù)后發(fā)生急性胰腺炎共15例,發(fā)生率為5.32%。單因素χ2檢驗(yàn)得出:十二指腸憩室(χ2=10.421,P=0.001)、插管困難(χ2=16.130,P=0.001)、胰管顯影(χ2=6.342,P=0.012)、操作時(shí)間(χ2=6.952,P=0.008)與ERCP術(shù)后胰腺炎的發(fā)生有關(guān)(P值0.05)。多因素分析結(jié)果顯示:插管困難(OR=11.166,P=0.002)和胰管顯影(OR=14.270,P=0.003)是ERCP術(shù)后發(fā)生急性胰腺炎的危險(xiǎn)因素。結(jié)論:十二指腸憩室、插管困難、胰管顯影、操作時(shí)間與ERCP術(shù)后急性胰腺炎的發(fā)生有關(guān)。插管困難和胰管顯影是影響ERCP術(shù)后發(fā)生急性胰腺炎的獨(dú)立危險(xiǎn)因素。通過(guò)分析這些危險(xiǎn)因素,為臨床預(yù)防提供了依據(jù),有利于降低ERCP術(shù)后急性胰腺炎的發(fā)生,減少醫(yī)療成本,減輕患者痛苦。
[Abstract]:Objective: to investigate the risk factors of acute pancreatitis after therapeutic ERCP. Methods: to provide evidence for prevention of postoperative acute pancreatitis. The clinical data of 282 patients with choledocholithiasis treated with ERCP from May 2014 to June 2016 in Department of Digestive Medicine and General surgery of the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. Self-related factors and operative related factors. Univariate 蠂 2 test and multivariate logistic regression analysis were performed with SPSS17.0 software. The independent risk factors of acute pancreatitis after ERCP were screened out. Results 15 cases of acute pancreatitis occurred after ERCP in 282 cases of choledocholithiasis. The incidence rate was 5.32.The single factor 蠂 2 test showed that the duodenal diverticulum (蠂 2 + 10.421) was 0.001, and the intubation was difficult (蠂 2 ~ (2) 16.130 / P ~ (0.001)). Pancreatic duct was developed (蠂 ~ 2 ~ (6.342)) and operation time was (蠂 ~ (2) ~ (6.952)). P0. 008) was related to the occurrence of pancreatitis after ERCP. The results of multivariate analysis showed that it was difficult to intubate. Conclusion: duodenal diverticulum is difficult to intubate. Pancreatic duct development. The operative time was related to the occurrence of acute pancreatitis after ERCP. The difficulty of intubation and the development of pancreatic duct were independent risk factors for acute pancreatitis after ERCP. It is helpful to reduce the incidence of acute pancreatitis after ERCP, reduce the cost of medical treatment and alleviate the suffering of patients.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R576

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