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胆总管结石患者并发化脓性胆管炎的预警因素分析
Risk factors for pyogenic cholangitis in patients with common bile duct stones
文章发布日期:2016年12月07日  来源:  作者:王春秋,马颖才,朱智勇,等  点击次数:1815次  下载次数:386次

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【摘要】:目的探讨胆管结石并发化脓性胆管炎的早期危险因素。方法收集2013年1月-2015年6月就诊于青海省人民医院的胆总管结石患者入院3 d内的临床资料,包括性别、年龄、CRP、ALP、GGT、DBil、胆总管直径、结石直径、氧分压、尿胆原。将研究对象分为单纯胆管结石组和胆管结石并发化脓性胆管炎组;2组间计量资料比较采用独立样本t检验,计数资料比较采用χ2检验,危险因素筛选采用二元logistic回归分析。结果单纯胆管结石组和胆管结石并发化脓性胆管炎组比较,性别、CRP、ALP、GGT、DBil、胆总管直径、氧分压、尿胆原等差异均有统计学意义(P值均<0.05);进一步二元logistic回归分析显示性别[比值比(OR)=4.24,P<0.001]、CRP≥3 mg/dl(OR=2..010)、DBil>73 μmol/L(OR=2.57,P=0.020)、胆总管直径≥13 mm(OR=8.21,P<0.001)、氧分压<80 mm Hg(OR=31.23,P<0.001)、尿胆原≥2+(OR=2.28,P<0.001)是胆管结石并发化脓性胆管炎的危险预警因素。结论胆总管结石并发化脓性胆管炎可早期发现危险因素,以便更好的选择手术时机和方式。
【Abstract】:ObjectivesTo investigate the early risk factors for pyogenic cholangitis in patients with common bile duct stones. MethodsThe clinical data of patients with common bile duct stones within 3 days after admission, who visited Qinghai Provincial People′s Hospital from January 2013 to June 2015, were collected, including sex, age, C-reactive protein (CRP), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), direct bilirubin (DBil), diameter of the common bile duct, diameter of the stones, oxygen partial pressure, and urobilinogen. The patients were divided into bile duct stone group and bile duct stone-pyogenic cholangitis group. The independent samples t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and the binary logistic regression was used for the screening for risk factors. ResultsThere were significant differences in sex, CRP, ALP, GGT, DBil, diameter of the common bile duct, oxygen partial pressure, and urobilinogen between the bile duct stone group and the bile duct stone-pyogenic cholangitis group (all P<0.05). The binary logistic regression analysis showed that sex (OR=4.24, P<0.001), CRP ≥3 mg/dl (OR = 2.39, P = 0.030), GGT≥224 U/L (OR=4.33, P<0.001), ALP ≥198 U/L (OR=2.76, P=0.010), DBil >73 μmol/L (OR=2.57, P=0.020), diameter of the common bile duct ≥13 mm (OR=8.21, P<0.001), oxygen partial pressure <80 mm Hg (OR=31.23, P<0.001), and urobilinogen ≥2+ (OR=2.28, P<0.001) were risk factors for pyogenic cholangitis in patients with common bile duct stones. ConclusionThe risk factors for pyogenic cholangitis in patients with common bile duct stones can be detected in early stage, which helps with the selection of surgical timing and procedure.
【关键字】:胆总管结石;胆管炎;危险因素
【Key words】:choledocholithiasis; cholangitis; risk factors
【引证本文】:王春秋, 马颖才, 朱智勇, 等. 胆总管结石患者并发化脓性胆管炎的预警因素分析[J]. 临床肝胆病杂志, 2017, 33(1): 95-97.

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