|本期目录/Table of Contents|

胰腺癌患者行内镜逆行胰胆管造影术放置胰管支架后发生胰腺炎的危险因素分析

《现代肿瘤医学》[ISSN:1672-4992/CN:61-1415/R]

期数:
2019年20期
页码:
3667-3670
栏目:
论着(消化·泌尿系肿瘤)
出版日期:
2019-09-08

文章信息/Info

Title:
The risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography with pancreatic stent placement in patients with pancreatic cancer
作者:
贺继东1;?张军鹏1;?董丽娟1;?党学锋1;?王 莉2
1.宝鸡市人民医院,陕西 宝鸡 721000;2.宝鸡市中心医院,陕西 宝鸡 721008
Author(s):
He Jidong1;?Zhang Junpeng1;?Dong Lijuan1;?Dang Xuefeng1;?Wang Li2
1.Baoji People's Hospital,Shaanxi Baoji 721000,China;2.Baoji Central Hospital,Shaanxi Baoji 721008,China.
关键词:
胰腺支架;?内镜逆行胰胆管造影术;?内镜逆行胰胆管造影术后胰腺炎
Keywords:
pancreatic stent;?endoscopic retrograde cholangiopancreatography;?post-endoscopic retrograde cholangiopancreatography pancreatitis
分类号:
R735.9
DOI:
10.3969/j.issn.1672-4992.2019.20.027
文献标识码:
A
qq自动领红包软件:
目的:确定胰腺癌患者行内镜逆行胰胆管造影术放置胰管支架后发生胰腺炎的危险因素。方法:收集2016年4月至2018年7月62名初次接受内镜逆行胰胆管造影术,并在术中插入了胰腺支架预防术后急性胰腺炎的胰腺癌患者的资料。其中术后发生急性胰腺炎患者24例,未发生胰腺炎患者38例,采用固定回归和随机效应的Logistic回归模型对ERCP术放置胰管支架后发生胰腺炎患者进行建模。结果:Logistic回归显示年轻、女性、高血压、插管时间超过60 min、胰管支架放置于胰头、插管次数为ERCP术放置胰管支架后发生胰腺炎的危险因素。高血压、插管时间超过60 min、胰管支架放置于胰头为其独立危险因素。结论:高血压,插管时间过长和胰管支架放置在胰头部位,决定了胰腺癌患者行内镜逆行胰胆管造影术放置胰管支架后更容易发生胰腺炎。
Abstract:
Objective:To determine the risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography with pancreatic stent placement in patients with pancreatic cancer.Methods:The clinical data of 62 patients with pancreatic cancer who underwent endoscopic retrograde cholangiopancreatography(ERCP) with pancreatic stents were inserted during the procedure to prevent postoperative acute pancreatitis for the first time from April 2016 to July 2018 were collected.There were 24 patients with acute pancreatitis and 38 patients without pancreatitis after ERCP.Fixed regression and randomized logistic regression models were used to model pancreatitis patients with pancreatic duct stent placement after ERCP.Results:Logistic regression model showed that young,female,hypertension,intubation time more than 60 min,pancreatic duct stent placed in the head of the pancreas,intubation times were risk factors for pancreatitis occurred after placement of pancreatic stent in ERCP.Hypertension,intubation time more than 60 min,and pancreatic duct stents placed on the head of pancreas were independent risk factor.Conclusion:Hypertension,prolonged intubation time and placement of pancreatic duct stents in the head of the pancreas determine that endoscopic retrograde cholangiopancreatography (ERCP) is more prone to pancreatitis after placement of pancreatic duct stents in patients with pancreatic cancer.

参考文献/References

[1] Cao J,Peng C,Ding X,et al.Risk factors for post-ERCP cholecystitis:A single-center retrospective study[J].BMC Gastroenterol,2018,18(1):128-130.
[2] YANG Aiming.Endoscopic ultrasonography combined with endoscopic retrograde cholangiopancreatography for the treatment of biliary and pancreatic diseases [J].J Clin Hepatol,2018,34(3):482-485.[杨爱明.超声内镜与经内镜逆行胰胆管造影联合治疗胆胰疾病[J].临床肝胆病杂志,2018,34(3):482-485.]
[3] CHEN Wenhua,LIN Jun,WANG Jianping,et al.Risk factors and preventive measures of pancreatitis after ERCP [J].International Journal of Digestive Diseases,2018,38(2):79-83.[陈文华,林军,王剑屏,等.ERCP术后胰腺炎的危险因素及预防措施[J].国际消化病杂志,2018,38(2):79-83.]
[4] Choi YH,Jang DK,Lee SH,et al.Utility of serum phosphate as a marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis[J].United European Gastroenterol J,2018,6(6):895-901.
[5] JIA Guofa,SHAN Hong,WU Liying,et al.Preventive effect of pancreatic duct stent on pancreatitis after ERCP in patients with risk factors[J].J Gastroenterol,2017,22(9):548-552.[贾国法,单红,吴丽颖,等.胰管支架对伴有危险因素的患者发生ERCP术后胰腺炎的预防作用[J].胃肠病学,2017,22(9):548-552.]
[6]HE Liu,ZHANG Mingguang.Analysis of risk factors for acute pancreatitis after therapeutic ERCP[J].Hebei Medical Journal,2018,24(1):115 -118.[何柳,张铭光.治疗性ERCP术后发生急性胰腺炎的危险因素分析[J].河北医学杂志,2018,24(1):115 -118.]
[7]CHEN Yueli,ZHANG Jianguo,WANG Zhaoyue,et al.Therapeutic effect of indomethacin on prevention of pancreatitis after ERCP in elderly patients with common bile duct stones[J].Chongqing Medical Journal,2018,47(9):1212-1214.[陈月莉,张建国,王昭月,等.吲哚美辛预防老年胆总管结石患者ERCP术后胰腺炎的疗效分析[J].重庆医学杂志,2018,47(9):1212-1214.]
[8] ZHANG Yafei,PAN Weikang,WU Aili,et al.Clinical analysis of postoperative pancreatitis in patients with postoperative nasobiliary drainage after therapeutic ERCP[J].Air Force Medical Journal,2018,33(1):32-35.[张亚飞,潘伟康,武阿丽,等.治疗性ERCP术后鼻胆管引流预防患者术后胰腺炎的临床效果分析[J].空军医学杂志,2018,33(1):32-35.]
[9] Hiroshi M,Fumihiro U,Yuki K,et al.Analysis of the risk factors for severity in post endoscopic retrograde cholangiopancreatography pancreatitis:The indication of prophylactic treatments[J].World J Gastrointest Endosc,2017,9(04):189-195.
[10]TAN Zhi.Effect of therapeutic endoscopically assisted ERCP on complications of biliary pancreatitis[J].Clinical Medicine,2016,36(10):96-97.[谭智.治疗性内镜辅助下ERCP术对胆源性胰腺炎并发症的影响[J].临床医学,2016,36(10):96-97.]
[11]SHEN Yingzhou,WANG Kuangjing,HUANG Jin,et al.Evaluation of early detection and diagnosis of pancreatitis after endoscopic retrograde cholangiopancreatography with serum lipase,interleukin-6 and platelet activating factor[J].Journal of Clinical Military Surge,2018,46(7):737-740.[沈颖洲,王旷靖,黄锦,等.血清脂肪酶、白细胞介素-6及血小板活化因子对内镜逆行胰胆管造影术后胰腺炎早期预测及诊断价值研究[J].临床军医杂志,2018,46(7):737-740.]
[12] Morales SJ,Sampath K,Gardner TB.A review of prevention of post-ERCP pancreatitis[J].Gastroenterol Hepatol,2018,14(5):286-292.
[13] JIA Guofa,SHAN Hong,WU Liying,et al.Preventive effect of pancreatic duct stent on pancreatitis after ERCP in patients with risk factors[J].Chin J Gastroenterol,2017,22(09):548-552.[贾国法,单红,吴丽颖,等.胰管支架对伴有危险因素的患者发生ERCP术后胰腺炎的预防作用[J].胃肠病学,2017,22(09):548-552.]
[14]ZHANG Zixu,GAO Feng,FENG Yan,et al.Analysis and discussion of risk factors related to pancreatitis after ERCP[J].Xinjiang Medical Journal,2017,47(9):955-957.[张子旭,高峰,冯燕,等.ERCP术后胰腺炎的相关危险因素分析和探讨[J].新疆医学,2017,47(9):955-957.]
[15] YANG Shengye,WANG Xiangping,ZHANG Rongchun,et al.Effect of intubation time on pancreatitis after endoscopic retrograde cholangiopancreatography[J].Chinese Journal of Digestive Endoscopy,2017,34(4):250-253.[杨盛烨,王向平,张荣春,等.插管时间对经内镜逆行胰胆管造影术后胰腺炎的影响[J].中华消化内镜杂志,2017,34(4):250-253.]
[16] ZHENG Chao,MENG Xianzhi.Prevention strategy of pancreatitis after ERCP:drugs and technology[J].Laboratory Medicine and Clinical Medicine,2017,14(12):1840-1843.[郑朝,孟宪志.ERCP术后胰腺炎的预防策略:药物与技术[J].检验医学与临床,2017,14(12):1840-1843.]

备注/Memo

备注/Memo:
-
更新日期/Last Update: 1900-01-01