胆结石治疗后发生胰腺炎的危险因素,使用内镜逆向胆血管细胞学
Feibao Jiang1, Jilong Zhang1, Zhenghua Hu1
1Surgical Department Ward One, People's Hospital of Changshan City, Changshan 324200, Zhejiang Province, China.
African health sciences
|January 15, 2024
概括
对于胆结石进行内镜逆行胆管细胞造影 (ERCP) 的患者,面临胰腺炎的风险. 关键的危险因素包括年轻年龄,胆囊壁厚度和多次输管,而胰腺管道支架可能会减少发病率.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术 进行内镜手术
- 胆道疾病 胆道疾病
背景情况:
- 胆结石在内镜逆行胆血管瘤造影术 (ERCP) 后具有显著的胰腺炎发病风险.
- 了解风险因素对于管理ERCP后胰腺炎至关重要.
- ERCP是一种用于治疗胆结石的常见程序.
研究的目的:
- 确定和分析患有胆结石的患者在ERCP后与胰腺炎相关的风险因素.
- 为了评估ERCP后胰腺炎的诺莫格拉姆模型的预测准确度.
主要方法:
- 分析了2017年10月至2020年10月期间治疗胆结石的193名患者的队列.
- 患者被分为胰腺炎 (n=55) 和非胰腺炎 (n=138) 组.
- 使用多变量逻辑回归和接收器运行特征 (ROC) 曲线来识别风险因素并评估模型性能.
主要成果:
- 在ERCP后发生胰腺炎的发病率为28.50%.
- 确定的危险因素包括年轻年龄,长期的疾病过程,胆囊壁厚度>3毫米,沙状石块,胰腺疾病史,多次输管 (≥2) 和没有胰腺管道支架.
- 胰腺管支架与胰腺炎的发病率显著降低 (11.84%与39.31%) 和ERCP后血清氨酶水平降低.
结论:
- 年轻的患者,具有特定胆结石特征的患者,以及接受更复杂的ERCP手术的患者患胰腺炎的风险更高.
- 胰腺管支架似乎是预防ERCP后胰腺炎的保护因素.
- 开发的诺莫格拉姆模型在预测胰腺炎风险方面表现出高准确性.
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