ERCP后胰腺炎危险因素分析与预防

目的探讨ERCP后胰腺炎的多种可能危险因素,便于更好地预防。方法回顾性分析956例行ERCP患者的有关临床资料。探讨术中静脉麻醉、胰管显影、胆管插管失败、EST、ERCP操作时间、胆管扩张、黄疸、胰腺炎病史、高血压、糖尿病、性别、年龄等方面的可能危险因素。结果胰管显影、胆管插管失败、EST、ERCP操作时间延长、无黄疸、胰腺炎病史、中青年龄均使ERCP后胰腺炎发生率升高（p〈0.01）,而术中静脉麻醉、胆管扩张、高血压、糖尿病、性别均未明显影响行ERCP后胰腺炎发生率（p〉0.05）。结论行ERCP后胰腺炎危险因素众多。其中,胰管显影、胆管插管失败、EST、ERCP操作时间延长、无黄胆、胰腺炎病史、中青年龄等均为ERCP后胰腺炎的高危因素,而术中静脉麻醉、胆管扩张、高血压、糖尿病、性别等不是ERCP后胰腺炎的高危因素。通过各种预防措施,ERCP后胰腺炎发生率可以下降。

The analysis of risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography and prevention strategy

Objective To analyze the possible risk factors for post -endoscopic retrograde cholangiopancreatography pancreatitis （PEP）. Methods 956 patients who underwent endoscopic retrograde cholangiopancreatography （ERCP） in Chongqing the Third Hospital from July 1997 to October 2007 were analyzed retrospectively. The investigated factors including intraoperative intravenous analgesia, pancreatic duct opacification, bile duct cannulation failure, endoscopic sphincterotomy （EST） , duration of ERCP procedure, bile duct dilatation ,jaundice, the history of pancreatitis, hypertension, diabetes, gender and age. Results The incidence of PEP significantly increased in patients with pancreatic duct opacification, bile duct cannulation failure, EST, long duration of ERCP, non - jaundice, history of pancreatitis, young or middle age （p 〈 0.01 ）. While intraoperative intravenous analgesia, bile duct dilatation, hypertension, diabetes and gender didnt influence the incidence of PEP （p 〉 0.05 ）. Conclusions Pancreatic duct opacification, bile duct cannulation failure, EST, long duration of ERCP, non -jaundice, history of pancreatitis and young or middle age are all risk factors for PEP. While intraoperative intravenous analgesia, bile duct dilatation, hypertension, diabetes and gender are not risk factors for PEP. Proper prevention strategy can decrease the incidence of PEP.