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目的探讨ERCP(endoscopic retrograde cholangiopancreatography,ERCP)术后并发胰腺炎的危险因素,以更好的预防ERCP术后胰腺炎的发生。方法收集2010年10月~2013年7月于山西医科大学第一附属医院住院行ERCP检查或治疗的168例患者的住院资料,符合标准153例,采用单因素及多因素分析方法分析患者性别、年龄、肥胖、黄疸、麻醉方式、插管次数、胰管显影次数、怀疑乳头括约肌功能障碍、乳头括约肌切开、鼻胆管引流、胆管支架置入等因素与ERCP术后胰腺炎发生的关系。结果 153例行ERCP术患者中发生胰腺炎19例,发生率为12.42%。单因素分析显示在所选择的25个因素中有9个因素有统计学意义,将有统计意义因素行多因素非条件Logistic回归分析,筛选出4个变量,其中女性、怀疑乳头括约肌功能障碍、插管困难为ERCP术后胰腺炎的独立危险因素、而鼻胆管引流为ERCP术后胰腺炎的保护因素。结论女性、怀疑乳头括约肌功能障碍、插管困难是ERCP术后胰腺炎的高危因素,而鼻胆管引流可预防ERCP术后胰腺炎的发生。
Objective To investigate the risk factors of postoperative ERCP complicated with pancreatitis in order to better prevent the occurrence of pancreatitis after ERCP. Methods A total of 168 hospitalized patients who underwent ERCP examination or treatment at the First Affiliated Hospital of Shanxi Medical University from October 2010 to July 2013 were recruited. The data were consistent with the standard of 153 cases. Univariate and multivariate analysis were used to analyze the gender, Age, obesity, jaundice, anesthesia, number of intubation, number of pancreatic duct imaging, suspected spermatic sphincter dysfunction, nipple sphincterotomy, nasobiliary drainage, biliary stenting and other factors and ERCP postoperative pancreatitis. Results In 153 patients with ERCP, 19 cases of pancreatitis occurred, the incidence was 12.42%. Univariate analysis showed that among the 25 factors selected, 9 were statistically significant. There were statistically significant factors in the multivariate non-conditional Logistic regression analysis, and four variables were screened, including women, suspected nipple sphincter dysfunction, Intubation difficulties as an independent risk factor for post-ERCP pancreatitis, and nasobiliary drainage as a protective factor for post-ERCP pancreatitis. Conclusions Women, suspected spermatic sphincter dysfunction and difficult intubation, are risk factors for post-ERCP pancreatitis, whereas nasobiliary drainage can prevent post-ERCP pancreatitis.