经皮肝穿刺胆道取石治疗胆总管结石患者影响引流持续时间的因素分析*

doi:10.3969/j.issn.1672-5069.2022.04.033

摘要/Abstract

摘要： 目的探讨影响经皮肝穿刺胆道引流(PTBD)治疗胆总管结石(CBDS)患者引流持续时间的因素。方法 2019年4月～2021年3月我院收治的112例CBDS患者均接受PTBD治疗。收集临床资料,以PTBD平均引流时间加标准差之和为截断点,将患者分为PTBD 持续时间延长组和正常组,应用多因素Logistic回归分析影响引流延长的因素。结果在112例CBDS患者中,109例(97.3%)患者成功取出结石,其中81例胆道引流时间短于17天,另28例超过17天;PTBD持续时间延长组血清总胆红素【(38.1±7.3)μmol/L对(24.2±6.2)μmol/L】、淀粉酶【(403.7±15.6)U/L对(92.7±13.2)U/L】、ALP【(302.3±52.1)U/L对(180.7±50.2)U/L】、GGT【(176.6±16.7)U/L对(93.3±15.6)U/L】、C反应蛋白【(75.1±12.2)mg/L对(56.9±10.3)mg/L】和结石直径【(16.9±2.5)mm对(11.3±2.1)mm】等均显著高于PTBD持续时间正常组,差异有统计学意义(P＜0.05);多因素Logistic回归分析显示血清总胆红素(OR:4.092,95%CI:1.684～9.944)和淀粉酶水平(OR:3.277,95%CI:1.348～7.965)及结石直径(OR:3.651,95%CI:1.502～8.873)是影响CBDS患者PTBD持续时间的独立因素(P＜0.05)。结论采用PTBD治疗CBDS患者成功率高,了解一些容易导致引流时间延长的因素有助于做好术前准备和术后管理。

关键词: 胆总管结石, 经皮肝穿刺胆道引流术, 引流时间, 影响因素

Abstract: Objective The purpose of this study was to analyze the factors impacting duration of percutaneous transhepatic biliary drainage (PTBD) in patients with choledocholithiasis. Methods A total of 112 patients with common bile duct stones (CBDS) were encountered in our hospital between April 2019 and March 2021, and all patients were treated with PTBD. The patients were divided post-operationally into normal biliary drainage group with mean plus deviation drainage time and prolonged drainage group with longer drainage time. The factors impacting the duration of PTBD in patients with CBDS were analyzed by multivariate Logistic regression. Results Out of the 112 patients with CBDS, the biliary stones were successfully removed in 109 patients(97.3%), with prolonged biliary drainage time in 28 cases; there were significant differences as respect to serum bilirubin levels [(38.1±7.3)μmol/L vs. (24.2±6.2)μmol/L], serum amylase levels [(403.7±15.6)U/L vs.(92.7±13.2)U/L], serum ALP levels [(302.3±52.1)U/L vs. (180.7±50.2)U/L], serum GGT levels [(176.6±16.7)U/L vs. (93.3±15.6)U/L], serum C-reactive proteins [(75.1±12.2)mg/L vs. (56.9±10.3)mg/L] and the diameters of stones [(16.9±2.5)mm vs. (11.3±2.1)mm] between the two groups(P＜0.05); the multivariate Logistic analysis showed that serum bilirubin levels (OR:4.092, 95%CI:1.684-9.944), serum amylase levels (OR:3.277, 95%CI: 1.348-7.965) and the diameter of stones (OR:3.651, 95%CI:1.502-8.873) were the risk factors impacting the duration of biliary drainage(P＜0.05). Conclusion The treatment of patients with CBDS by PTBD is successful, and our findings suggest the clinicians should take influencing factors of biliary drainage time into consideration in clinical practice in order to manage appropriately pre-operationally.

Key words: Choledocholithiasis, Percutaneous transhepatic biliary drainage, Drainage time, Influencing factors

彭书甲, 周帅. 经皮肝穿刺胆道取石治疗胆总管结石患者影响引流持续时间的因素分析^*[J]. 实用肝脏病杂志, 2022, 25(4): 587-590.

Peng Shujia, Zhou Shuai. Analysis of factors impacting duration of percutaneous transhepatic biliary drainage in patients with choledocholithiasis[J]. Journal of Practical Hepatology, 2022, 25(4): 587-590.

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经皮肝穿刺胆道取石治疗胆总管结石患者影响引流持续时间的因素分析^*

Analysis of factors impacting duration of percutaneous transhepatic biliary drainage in patients with choledocholithiasis

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