治疗性内镜下逆行胰胆管造影术后急性胰腺炎高危因素分析

[目的]探索治疗性内镜下逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)术后急性胰腺炎(PEP)的高危因素与防治策略。[方法]运用单因素分析方法分析592例治疗性ERCP术后患者并发PEP的原因及防治措施。[结果]592例患者中,35例(5.9%)并发PEP,其中33例均为轻型胰腺炎,均经内科综合治疗后痊愈;2例为重症胰腺炎,1例治愈出院,1例死亡。与诱发PEP相关的高危因素有:女性,插管困难,既往有胰腺炎或胰腺癌,胰腺管显影或导丝插入胰管。[结论]治疗性ERCP发生PEP的因素不仅与患者自身临床因素有关,且与医师的操作技术有很大关系,改善患者身体条件、提高医师操作水平可减少PEP的发生。

Analysis of the high-risk factors of acute pancreatitis post endoscopic retrograde cholangiopancreatography

[Objective]To explore the high risk factors of post endoscopic retrograde cholangiopancre- atography （ERCP） pancreatitis （PEP）. I-Methods]Retrospectively analyzed 592 cases carried out with ther- apeutic ERCP in our hospital between July 2010 to May 2013 and investigated the etiology and management of PEP by univariate analysis. [Result]Thirty-five patients（5.9 %）developed PEP, among witch 33 patients developed mild PDP and all of the patients were cured through comprehensive internal medical teat- ment. Two patients developed severe PEP, and one patient recovered while one patient died. The high risk factors of PEP are extracted and listed below： women, difficult intubation, previous pancreatic disease, vi- sualization of the pancreatic duct,zebra guidewire inserted into the pancreatic duct. [Conclusion]PEP is re- lated to the characteristics of patients as well as the skills of the endoscopes, Improving patients ~ constitute and enhancing the level of technical operating can decrease the occurance of PEP.