塑料胆管支架置入的难治性胆总管结石患者发生支架堵塞的影响因素分析

田雯; 周中银

doi:10.3969/j.issn.1001-5256.2020.05.026

塑料胆管支架置入的难治性胆总管结石患者发生支架堵塞的影响因素分析

DOI: 10.3969/j.issn.1001-5256.2020.05.026

田雯,
周中银

武汉大学人民医院消化内科，消化系统疾病湖北省重点实验室

基金项目:

湖北省自然科学基金项目（2011CHB025）；

详细信息

中图分类号: R657.42
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出版历程
- 出版日期: 2020-05-20

Influencing factors for stent obstruction after endoscopic retrograde biliary drainage in patients with refractory common bile duct stones

Hubei Key Laboratory of Digestive System Diseases, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, China

Research funding:

摘要

摘要:
目的探讨塑料胆管支架置入（ERBD）治疗难治性胆总管结石术后支架堵塞的影响因素。方法选取2014年1月-2019年5月于武汉大学人民医院因难治性胆总管结石行ERBD治疗,均于术后6个月再次入院取出支架的患者126例,根据取出支架的情况分为堵塞组（n=28）和通畅组（n=98）,比较2组的一般资料、各项指标。正态分布的计量资料2组间比较采用独立样本t检验,非正态分布的计量资料2组间比较采用Mann-WhitneyU检验;计数资料组间比较采用χ2检验;采用多因素logistics回归分析术后支架堵塞的影响因素。结果 126例患者中有28例在取支架时发现堵塞,支架堵塞率为22. 2%。单因素分析示2组间WBC、中性粒细胞百分比（Neu%）、ALP、GGT、亮氨酸氨肽酶（LAP）、乳头括约肌切开术（EST）、感染、阿司匹林、支架类型比较,差异均有统计学意义（P值均<0. 05）。多因素logistic回归分析显示,WBC[OR（95%CI）:1. 232（1. 033～1. 470）]、Neu%[OR（95%CI）:1. 263（1. 021～1. 562）]、AL...
- 胆总管结石病 /
- 引流术 /
- 支架 /
- 导管阻塞
Abstract:
Objective To investigate the influencing factors for stent obstruction after endoscopic retrograde biliary drainage(ERBD) forrefractory common bile duct stones.Methods A total of 126 patients who underwent ERBD for refractory common bile duct stones inRenmin Hospital of Wuhan University from January 2014 to May 2019 and were readmitted for stent removal at 6 months after surgery wereenrolled, and according to the condition of stent removal, they were divided into obstruction group and unobstructed group. General data andrelated indices were compared between the two groups. The independent samplest-test was used for comparison of normally distributed con-tinuous data between groups, and the Mann-WhitneyUtest was used for comparison of non-normally distributed continuous data betweengroups; the chi-square test was used for comparison of categorical data between groups; a multivariate logistic regression analysis was usedto investigate the influencing factors for stent obstruction after surgery.Results Among the 126 patients, 28 were found to have stent ob-struction during removal, with a stent obstruction rate of 22. 2%. The univariate analysis showed that there were significant differences be-tween the two groups in white blood cell count(WBC), percentage of neutrophils(Neu%), alkaline phosphatase(ALP), gamma-glu-tamyl transpeptidase, leucine aminopeptidase, endoscopic sphincterotomy(EST), infection, aspirin, and stent type(allP< 0. 05). Themultivariate logistic regression analysis showed that WBC[OR(95% CI):1. 232(1. 033-1. 470)], Neu% [OR(95% CI):1. 263(1. 021-1. 562)], ALP[OR(95% CI):1. 013(1. 004-1. 022)], EST[ OR(95% CI):5. 890(1. 114-31. 139)], infection[ OR(95% CI):17. 317(1. 349-222. 349)], and stent type[OR(95% CI):0. 144(0. 022-0. 937)] were independent influencing factors for postopera-tive stent occlusion(allP< 0. 05).Conclusion Patients with elevated WBC/Neu%/ALP, intraoperative EST, and preoperative secondaryinfection have a high risk of postoperative stent obstruction, and close follow-up and early prevention should be performed for such patients.The double pigtail stent can effectively reduce the rate of postoperative stent obstruction.
- choledocholithiasis /
- drainage /
- stents /
- catheter obstruction

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参考文献(20)

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