目的:分析經(jīng)內(nèi)鏡逆行胰膽管造影術(shù)（Endoscopic Retrograde Cholangiopancreatography,ERCP）術(shù)后胰腺炎（post-ERCP pancreatitis,PEP）及高淀粉酶血癥（Hyperamylasemia）的危險(xiǎn)因素及研究預(yù)防性應(yīng)用腎上腺素的效果。方法:本研究選取于河北醫(yī)科大學(xué)第二醫(yī)院在膽道微創(chuàng)外科2017年01月至2018年01月,術(shù)前診斷為膽總管結(jié)石行ERCP的患者,共239例符合納入標(biāo)準(zhǔn)。設(shè)計(jì)表格,收集相關(guān)資料。最終確定ERCP術(shù)后胰腺炎及高淀粉酶發(fā)生率的相關(guān)危險(xiǎn)因素、獨(dú)立危險(xiǎn)因素及預(yù)防性應(yīng)用腎上腺素的效果。將相關(guān)危險(xiǎn)因素進(jìn)行單因素分析,對(duì)有統(tǒng)計(jì)學(xué)意義（P<0.05）的因素進(jìn)行多因素logistic回歸性分析。結(jié)果:納入239例患者中,9例患者出現(xiàn)ERCP術(shù)后胰腺炎,發(fā)生率為3.76%（9例/239例）,76例患者被臨床診斷為ERCP術(shù)后高淀粉酶血癥,發(fā)生率為31.79%（76例/239例）。PEP單因素分析取石網(wǎng)籃進(jìn)入胰管、膽總管結(jié)石直徑（≤0.6cm）、困難插管（≥10分鐘）為危險(xiǎn)因素,腎上腺素為保護(hù)性因素。PEP多因素分析... 

【文章來(lái)源】：河北醫(yī)科大學(xué)河北省

【文章頁(yè)數(shù)】：47 頁(yè)

【學(xué)位級(jí)別】：碩士

【文章目錄】：
中文摘要
英文摘要
英文縮寫(xiě)
前言
材料與方法
結(jié)果
附表
討論
結(jié)論
參考文獻(xiàn)
綜述 ERCP術(shù)后相關(guān)并發(fā)癥的防治進(jìn)展
    參考文獻(xiàn)
致謝
個(gè)人簡(jiǎn)歷


【參考文獻(xiàn)】：
期刊論文
[1]Post-endoscopic retrograde cholangiopancreatography pancreatitis: Risk factors and predictors of severity[J]. Ayman El Nakeeb,Ehab El Hanafy,Tarek Salah,Ehab Atef,Hosam Hamed,Ahmad M Sultan,Emad Hamdy,Mohamed Said,Ahmed A El Geidie,Tharwat Kandil,Mohamed El Shobari,Gamal El Ebidy.  World Journal of Gastrointestinal Endoscopy. 2016(19)
[2]十二指腸乳頭局部噴灑腎上腺素對(duì)膽總管結(jié)石ERCP術(shù)后胰腺炎的預(yù)防作用[J]. 王廣勇,施云星,呂礁,曾曉虹,周?chē)?guó)中,劉長(zhǎng)云,錢(qián)慧.  中華胰腺病雜志. 2015 (06)
[3]Preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: What can be done?[J]. Goran Hauser,Marko Milosevic,Davor Stimac,Enver Zerem,Predrag Jovanovi?,Ivana Blazevic.  World Journal of Gastroenterology. 2015(04)
[4]Endoscopic treatment of duodenal fistula after incomplete closure of ERCP-related duodenal perforation[J]. Dong Wook Yu,Man Yong Hong,Seung Goun Hong.  World Journal of Gastrointestinal Endoscopy. 2014(06)
[5]Placement of prophylactic pancreatic stents to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients: A meta-analysis[J]. Qing-Qing Shi,Xiao-Yi Ning,Ling-Ling Zhan,Guo-Du Tang,Xiao-Ping Lv.  World Journal of Gastroenterology. 2014(22)
[6]Effect of precut sphincterotomy on post-endoscopic retrograde cholangiopancreatography pancreatitis:A systematic review and meta-analysis[J]. Abhishek Choudhary,Jessica Winn,Sameer Siddique,Murtaza Arif,Zainab Arif,Ghassan M Hammoud,Srinivas R Puli,Jamal A Ibdah,Matthew L Bechtold.  World Journal of Gastroenterology. 2014(14)
[7]治療性ERCP術(shù)后胰腺炎危險(xiǎn)因素的Logistic回歸分析[J]. 陳小微,洪萬(wàn)東,吳小麗,黃慶科,朱啟槐.  實(shí)用醫(yī)學(xué)雜志. 2012(04)
[8]內(nèi)鏡下逆行膽胰管造影術(shù)（ERCP）診治指南（2010版）[J]. 中華醫(yī)學(xué)會(huì)消化內(nèi)鏡分會(huì)ERCP學(xué)組,胡冰,麻樹(shù)人,李兆申.  中國(guó)繼續(xù)醫(yī)學(xué)教育. 2010(06)
[9]Treating delayed endoscopic sphincterotomy-induced bleeding:Epinephrine injection with or without thermotherapy[J]. Yung-Kuan Tsou,Nai-Jen Liu,Jui-Hsiang Tang,Kai-Feng Sung,Chi-Liang Cheng,Ching-Song Lee.  World Journal of Gastroenterology. 2009(38)
[10]N-acetylcysteine does not prevent post-endoscopic retrograde cholangiopancreatography hyperamylasemia and acute pancreatitis[J]. Janusz Milewski,Grazyna Rydzewska,Malgorzata Degowska,Maciej Kierzkiewicz,Andrzej Rydzewski.  World Journal of Gastroenterology. 2006(23)



本文編號(hào)：3384002