胆管结石诱发急性重症胆管炎的危险因素分析
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郭雅 E-mail:long_di_ok@126.com

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Risk factors for severe acute cholangitis caused by bile duct stones
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    摘要:

    目的:探讨胆管结石诱发急性化脓性胆管炎的临床危险因素。
    方法:回顾性分析钦州市第二人民医院1998年6月—2009年3月诊治的436例胆管结石患者的临床资料,根据术前检查和术中探查,分为合并ACS组(74例)和非ACS组(362例),用单因素和多因素回归分析方法分析两组的年龄、性别、肝功能、合并胆囊结石、胆囊切除史、胆管结石的数量、胆管结石的直径、梗阻部位、胆管直径、胆管炎病史、胆道手术史、合并糖尿病、合并心血管疾病、合并呼吸疾病等14个因素与ACS的相关性,从而得出胆管结石诱发ACS的相关危险因素。
    结果:436例患者中有74例并发ACS,占16.97%。单因素分析表明,年龄、肝功能、梗阻部位、胆管炎病史、胆道手术史、合并糖尿病是胆管结石诱发ACS的危险因素。多因素分析表明,年龄、胆道手术史、合并糖尿病是胆管结石诱发ACS的独立因素。
    结论:年龄、胆管手术史、合并糖尿病是胆管结石诱发ACS的最主要危险因素。了解胆管结石诱发ACS的危险因素对临床治疗胆管结石和预防ACS具有指导意义。

    Abstract:

    Objective: To analyze the clinical risk factors for inducing acute suppurative cholangitis (ASC) in patients with bile duct stones.
    Methods: Clinical data of 436 cases with bile duct stones from June 1998 to March 2009 in the Second Pepole′s Hospital of Qinzhou City were analysed retrospectively. Patients were divided into two groups: (1) ASC group, 74 cases. (2) Non-ASC group, 362 cases. Single and mutiple factors analysis were adopted to analyze the risk factors,such as age, sex, liver function, number of bile duct stones, stone diameter, site of bile duct obstruction, gallbladder stones, previous cholecystectomy, bile duct diameter, previous cholangitis, previous biliary surgery, diabetes mellitus, cardiovascular disease, and respiratory disease.
    Results: There were 74 cases of ASC, accouting for 16.74% of bile duct stone. The univariate analysis showed that age, liver function, site of bile duct obstruction, previous cholangitis, previous biliary surgery and diabetes mellitus were the high risk factors for inducing ACS. Meanwhile, the mutivariate analysis indicated that age, previous choledochotomy and diabetes mellitus were the independent factors for ACS.
    Conclusions: Age, previous biliary surgery and diabetes mellitus are the main high risk factors for inducing ACS in patients with bile duct stones. An understanding of the high risk factors for ACS in patients with bile duct stone serves as a guide for better treatment of bile duct stone and preventon of ACS.

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龙涤| 郭雅| 方富义| 闭永浩| 覃小雄| 文张.胆管结石诱发急性重症胆管炎的危险因素分析[J].中国普通外科杂志,2010,19(8):858-860.
DOI:10.7659/j. issn.1005-6947.2010.08.006

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  • 收稿日期:2009-09-09
  • 最后修改日期:2010-06-20
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  • 在线发布日期: 2010-08-15