治疗性经内镜逆行胰胆管造影术后胆道出血与原发疾病的关系

王群茹; 张勇; 牟东; 陈备金; 倪华; 高慧

doi:10.3969/j.issn.1001-5256.2017.05.021

治疗性经内镜逆行胰胆管造影术后胆道出血与原发疾病的关系

DOI: 10.3969/j.issn.1001-5256.2017.05.021

成都军区总院消化科

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中图分类号: R657.4
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- 出版日期: 2017-05-20

Association between hematobilia and primary disease after therapeutic endoscopic retrograde cholangiopancreatography

Department of Gastroenterology, General Hospital of Chengdu Military Region

摘要

摘要:
目的分析不同原发疾病类型患者行治疗性经内镜逆行胰胆管造影（ERCP）术后胆道出血的风险差异。方法回顾性分析2013年6月-2016年6月成都军区总医院收治的685例行治疗性ERCP的胰胆疾病患者临床资料。根据患者是否发生ERCP术后胆道出血,分为出血组（29例）和未出血组（656例）,评价原发疾病类型与出血风险之间的关系。计数资料2组间比较采用χ2检验;计量资料2组间比较采用独立样本t检验。结果 ERCP术后胆道出血的总体发生率为4.2%（29/685）;其中21例为早期出血,8例为迟发性出血。出血组患者合并高血压病发生率明显高于未出血组（65.5%vs 25.6%,χ2=22.286,P<0.001）。出血组壶腹部嵌顿结石（17.2%vs 4.6%,χ2=9.193,P=0.002）、胆管癌（10.3%vs 2.4%,χ2=6.437,P=0.011）、胰腺癌（10.3%vs3.0%,χ2=4.556,P=0.033）及壶腹部癌（6.9%vs 1.4%,χ2<...
- 胰胆管造影术,内窥镜逆行 /
- 胆道出血 /
- 手术后并发症
Abstract:
Objective To investigate the difference in the risk of hematobilia after therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in patients with different primary diseases.Methods A retrospective analysis was performed for the clinical data of 685 patients with pancreaticobiliary diseases who underwent therapeutic ERCP in General Hospital of Chengdu Military Region from June 2013 to June 2016.According to the presence or absence of hematobilia after ERCP, they were divided into bleeding group (29 patients) and non-bleeding group (656 patients) .The association between primary disease and the risk of bleeding was evaluated.The chi-square test was used for comparison of categorical data between groups, and the independent samples t-test was used for comparison of continuous data between groups.Results The overall incidence rate of hematobilia after ERCP was 4.2% (29/685) , and among these patients, 21 had early bleeding and 8 had delayed bleeding.The bleeding group had a significantly higher incidence rate of hypertension than the non-bleeding group (65.5% vs 25.6%, χ2=22.286, P<0.001) 2="5.356," .compared="" with="" the="" non-bleeding="" bleeding="" group="" had="" significantly="" higher="" proportions="" of="" patients="" impacted="" ampullar="" stones="" vs="" p="" cholangiocarcinoma="" pancreatic="" cancer="" and="" carcinoma="" .there="" were="" no="" significant="" differences="" between="" two="" groups="" in="" common="" bile="" duct="" acute="" pyogenic="" biliary="" inflammatory="" stenosis="" after="" surgery="" all="">0.05) .Conclusion Patients with impacted ampullar stones or malignant pancreaticobiliary diseases have a high risk of hematobilia after ERCP and should be given adequate preoperative preparation, effective intraoperative hemostasis, and strengthened postoperative prevention.
- cholangiopancreatography, endoscopic retrograde /
- hemobilia /
- postoperative complications

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参考文献(11)

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