胰腺癌患者行内镜逆行胰胆管造影术放置胰管支架后发生胰腺炎的危险因素分析

目的:确定胰腺癌患者行内镜逆行胰胆管造影术放置胰管支架后发生胰腺炎的危险因素。方法:收集2016年4月至2018年7月62名初次接受内镜逆行胰胆管造影术，并在术中插入了胰腺支架预防术后急性胰腺炎的胰腺癌患者的资料。其中术后发生急性胰腺炎患者24例，未发生胰腺炎患者38例，采用固定回归和随机效应的Logistic回归模型对ERCP术放置胰管支架后发生胰腺炎患者进行建模。结果:Logistic回归显示年轻、女性、高血压、插管时间超过60 min、胰管支架放置于胰头、插管次数为ERCP术放置胰管支架后发生胰腺炎的危险因素。高血压、插管时间超过60 min、胰管支架放置于胰头为其独立危险因素。结论:高血压，插管时间过长和胰管支架放置在胰头部位，决定了胰腺癌患者行内镜逆行胰胆管造影术放置胰管支架后更容易发生胰腺炎。

The risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography with pancreatic stent placement in patients with pancreatic cancer

Objective:To determine the risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography with pancreatic stent placement in patients with pancreatic cancer.Methods:The clinical data of 62 patients with pancreatic cancer who underwent endoscopic retrograde cholangiopancreatography(ERCP) with pancreatic stents were inserted during the procedure to prevent postoperative acute pancreatitis for the first time from April 2016 to July 2018 were collected.There were 24 patients with acute pancreatitis and 38 patients without pancreatitis after ERCP.Fixed regression and randomized logistic regression models were used to model pancreatitis patients with pancreatic duct stent placement after ERCP.Results:Logistic regression model showed that young,female,hypertension,intubation time more than 60 min,pancreatic duct stent placed in the head of the pancreas,intubation times were risk factors for pancreatitis occurred after placement of pancreatic stent in ERCP.Hypertension,intubation time more than 60 min,and pancreatic duct stents placed on the head of pancreas were independent risk factor.Conclusion:Hypertension,prolonged intubation time and placement of pancreatic duct stents in the head of the pancreas determine that endoscopic retrograde cholangiopancreatography (ERCP) is more prone to pancreatitis after placement of pancreatic duct stents in patients with pancreatic cancer.