Analysis of incidence and risk factors for ERCP-related adverse events in patients with primary sclerosing cholangitis
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摘要:
目的探讨原发性硬化性胆管炎(PSC)患者行经内镜逆行性胰胆管造影(ERCP)术后不良事件的发病率及其影响因素。方法选取2009年12月至2013年12月于邢台市第三医院行磁共振胰胆管造影(MRCP)诊断为PSC并行ERCP的患者共72例,监测并记录术后30 d不良事件的发病情况。采用单因素及多因素Logistic回归分析不良事件的发病率以及相关危险因素。结果全部72例患者中ERCP的成功率为94.4%(68/72),不良事件中胰腺炎和胆道感染的发病率最高(6.94%,4.17%),穿孔的发病率最低(1.38%)。单因素Logistic分析显示行胰管造影、乳头括约肌切开术患者发生不良事件的危险率均高于未进行者(OR=13.642,P=0.017;OR=7.381,P=0.000);导丝进入胰腺和进行胰管造影也增加了不良反应的发病率(OR=8.042,P=0.000;OR=2.651,P=0.032)。多因素Logistic回归分析结果显示导丝进入胰管(OR=4.547,95%CI:1.076~12.543)、胆道乳头括约肌切开术(OR=5.023,95%CI:2.643~18.321)与...
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关键词:
- 胆管炎,硬化性 /
- 胰胆管造影术,内窥镜逆行 /
- 手术后并发症 /
- 危险因素
Abstract:Objective To investigate the incidence and risk factors for endoscopic retrograde cholangiopancreatography( ERCP)- related adverse events in patients with primary sclerosing cholangitis( PSC). Methods This study included 72 patients who were diagnosed with PSC by magnetic resonance cholangiopancreatography and underwent ERCP in the Third Hospital of Xingtai City from December 2009 to December 2013. The incidence of postoperative adverse events within 30 d after ERCP was monitored and recorded. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for ERCP- related adverse events in PSC patients. Results The success rate of ERCP was 94. 4%( 68 /72). Among all adverse events,the incidence of pancreatitis and biliary tract infection were highest( 6. 94%and 4. 17%),while the incidence of perforation was lowest( 1. 38%). Univariate logistic regression analysis showed that the risk of adverse events was significantly higher in patients who underwent cholangiopancreatography and sphincterotomy than in those not undergoing these procedures( OR = 13. 642,P = 0. 017; OR = 7. 381,P = 0. 000); guide wire insertion and cholangiopancreatography also increased the incidence of adverse reactions( OR = 8. 042,P = 0. 000; OR = 2. 651,P = 0. 032). Multivariate logistic regression analysis showed that guide wire insertion( OR = 4. 547,95% CI: 1. 076- 12. 543) and biliary sphincterotomy( OR = 5. 023,95% CI: 2. 643- 18. 321) are associated with the incidence of ERCP- related adverse events. Conclusion Sphincterotomy and guide wire insertion can increase the risk of adverse events in PSC patients after ERCP.
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