急性胆道炎患者的发病率和结果:基于人口的研究
H F Fridgeirsson1, M Konradsson2, E Vesteinsdottir3
1Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Scandinavian journal of gastroenterology
|July 6, 2023
概括
早期内镜逆行性胆道血管细胞造影 (ERCP) 治疗急性胆道炎 (AC) 可缩短住院时间. 虽然早期ERCP患者有更严重的AC,但死亡率与接受后期ERCP患者相似.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 外科胃肠道外科手术
背景情况:
- 急性胆道炎 (AC) 是一种严重的胆道感染.
- 在AC管理中,内镜逆行性胆血管细胞造影 (ERCP) 的最佳时间仍在争论中.
- 早期干预与AC中的延迟ERCP需要进一步调查.
研究的目的:
- 在AC患者中比较早期 (24小时内) 和晚期ERCP之间的结果.
- 评估ERCP时间对住院,严重程度和死亡率的影响.
- 检查AC患者的整体预后.
主要方法:
- 未来的内镜数据库分析 (2010-2021年).
- 包括诊断为胆管炎的患者 (ICD-10 k83.0) 或胆管结石患有胆管炎的患者 (ICD-10 k80.3).
- 根据东京指导方针验证诊断和严重程度;根据败血症-3标准进行败血症分析.
主要成果:
- 包括240名患者;25%接受了早期ERCP.
- 早期 (4.9%) 和晚期 (2.5%) ERCP组之间30天死亡率没有显著差异.
- 早期ERCP与更严重的胆管炎 (31%对18%) 和败血症 (33%对19%) 相关,但住院时间较短 (4对6天).
结论:
- 在AC患者中,ERCP时间显著影响住院时间.
- 早期ERCP (24小时内) 导致短期住院,尽管出现更严重的疾病.
- 这些发现支持在AC管理中考虑早期的ERCP,以优化资源利用.
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