胆胰疾病患者内镜治疗前非梗阻性胃潴留危险因素的病例对照研究

目的 探讨胆胰疾病患者经内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)治疗前非梗阻性胃潴留发生的危险因素。方法 采用病例对照研究,选取ERCP术中发现非梗阻性胃潴留患者109例为病例组,按照1∶2比例匹配未发生胃潴留的218例患者作为对照组,对两组患者合并疾病、术前用药、实验室指标等临床资料进行比较,并使用Logistic回归分析筛出ERCP术前非梗阻性胃潴留发生的危险因素。结果 黄疸(OR=12.359,P<0.001)、阿片类药物使用(OR=3.009,P=0.001)、生长抑素使用(OR=2.445,P=0.033)、高血糖(OR=1.513,P=0.045)、低血钾(OR=4.634,P=0.001)及低血钠(OR=1.805,P=0.023),这6项因素与胆胰疾病患者ERCP术前非梗阻性胃潴留的发生有关。结论 除胃肠道器质性梗阻外,术前黄疸、使用生长抑素、使用阿片类药物、高血糖、低钾血症、低钠血症均为胆胰疾病患者ERCP术前胃潴留发生的危险因素。医护人员需对患者进行全面评估,对于有此类危险因素患者需及早干预。

Risk factors of non-obstructive gastric retention before endoscopic treatment in patients with biliopancreatic disease: a matched case-control study

Objective To investigate the risk factors of non-obstructive gastric retention before endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliopancreatic disease. Methods The matched case-control study included 109 patients with non-obstructive gastric retention before ERCP as the case group, and 218 patients without gastric retention as the control group. The patients" medical records including comorbidities, preoperative medication and laboratory indicators were compared between the two groups. Multivariate conditional logistic regression models were subsequently used to determine the risk factors for non-obstructive gastric retention before ERCP. Results Logistic regression revealed that the jaundice (OR=12.359, P<0.001), opiates use (OR=3.009, P=0.001), somatostatin use (OR=2.445, P=0.033), fasting hyperglycemia (OR=1.513, P=0.045), hypokalemia (OR=4.634, P=0.001) and hyponatremia (OR=1.805, P=0.023) were independent risk factors for non-obstructive gastric retention before ERCP in patients with biliopancreatic disease. Conclusion Except for gastrointestinal obstruction, jaundice, opiates use, somatostatin use, fasting hyperglycemia, hypokalemia and hyponatremia are all risk factors for gastric retention in patients with biliopancreatic disease. Comprehensive evaluation and early intervention for patients showing these risk factors are needed.