急性胆源性胰腺炎发病危险因素分析

doi:10.3969/j.issn.1007-3205.2023.12.014

河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (12): 1448-1452.doi: 10.3969/j.issn.1007-3205.2023.12.014

急性胆源性胰腺炎发病危险因素分析

内蒙古医科大学附属医院肝胆胰脾外科，内蒙古呼和浩特 010050

出版日期:2024-01-02 发布日期:2024-01-02
作者简介:杜军卫（1981-），男，内蒙古乌兰察布人，内蒙古医科大学附属医院副主任医师，医学硕士，从事肝胆胰脾外科疾病诊治研究。

Analysis of risk factors of acute biliary pancreatitis

Department of Hepatobiliary Surgery, the Affiliated Hospital of Inner Mongolia Medical University,
Inner Mongolia, Hohhot 010050, China

Online:2024-01-02 Published:2024-01-02

摘要/Abstract

摘要： 目的急性胆源性胰腺炎（acute biliary pancreatitis，ABP）为多因素综合所致，本文回顾分析胆囊结石继发肝外胆管结石病例的结石特点及胆管特征，以期了解ABP的危险因素及发病特点，为指导临床诊疗提供依据。
方法回顾性分析内蒙古医科大学附属医院肝胆胰脾外科住院治疗的胆道结石患者病历资料，对合并ABP和不合并ABP患者的临床特点、实验室指标及影像学特点等多项参数综合分析、分组比较。
结果合并ABP的胆囊结石继发肝外胆管结石患者共28例，包括轻症急性胰腺炎(mild acute pancreatitis,MAP)22例、中度重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)3例和急性重症胰腺炎(sever eacutepancreatitis，SAP)3例，共1例(3.6%)患者死亡。Logistics二元回归分析提示，胆囊管直径≥5 mm、胆囊内最小结石＜5 mm、胆囊内泥沙+块状结石及胰胆管合流异常四种因素与ABP发病高度相关（OR值分别为3.358、4.414、7.965和6.055）。
结论胆囊管增粗、胆囊内泥沙和块状小结石混合、胰胆管合流异常，与ABP发病高度相关，这些因素将为今后ABP诊疗乃至预警提供依据。

关键词: 胰腺炎, 胆囊结石病, 胆囊管直径

Abstract: Objective Acute biliary pancreatitis (ABP) is caused by multiple factors. The aim of this study was to retrospectively analyze the characteristics of gallstone and biliary duct in patients with gallstones secondary to extrahepatic bile duct stones, so as to understand the risk factors and pathogenesis of ABP, providing the evidence to guide clinical diagnosis and treatment.
Methods Retrospective analysis of medical records of patients with biliary stones admitted to the Department of Hepatobiliary Pancreatic and Splenic Surgery, the Affiliated Hospital of Medical University. Comprehensive analysis and grouping comparison were performed on clinical characteristics, laboratory indicators, and imaging characteristics of patients with and without ABP.
Results A total of 28 patients with gallstones secondary to extrahepatic bile duct stones were found to have ABP, including 22 with mild acute pancreatitis (MAP)， 3 with moderately severe acute pancreatitis (MSAP), and 3 with severe acute pancreatitis (SAP). One of 28 patients (3.6%) had a fatal outcome. Binary Logistics regression analysis revealed that diameter of cystic duct ≥5 mm, diameter of the smallest gallbladder stone ＜5 mm， mixed stone in the gallbladder, and pancreaticobiliary maljunction (PBM) remained highly correlated with ABP (OR value： 3.358, 4.414, 7.965 and 6.055, respectively).
Conclusion The thickening of cystic duct, mixing of sediment and blocky small stones in the gallbladder, and pancreaticobiliary maljunction are strongly associated with the onset of ABP, which will provide evidence for the diagnosis, treatment and early warning of ABP in the future.

Key words: pancreatitis, cholecystolithiasis, diameter of cystic duct ,

杜军卫, 靳君华. 急性胆源性胰腺炎发病危险因素分析 [J]. 河北医科大学学报, 2023, 44(12): 1448-1452.

DU Jun-wei, JIN Jun-hua. Analysis of risk factors of acute biliary pancreatitis [J]. Journal of Hebei Medical University, 2023, 44(12): 1448-1452.

[1]	张涛, 邹萍, 赵琦. 高脂血症胰腺炎患者血清血管紧张素转化酶2与巨噬细胞移动抑制因子水平检测及临床意义 [J]. 河北医科大学学报, 2023, 44(6): 724-728.
[2]	张冰1，朱国玲2*，孙秋1，吉瑞更1. 开滦集团400例急性胰腺炎流行病学及危险因素分析[J]. 河北医科大学学报, 2020, 41(6): 723-727.
[3]	张健，刘贤，郭雅丽，李亚强，徐宝宏*. 甲磺酸加贝酯联合CBP治疗SAP的效果及对炎症“瀑布效应”相关因子的影响[J]. 河北医科大学学报, 2020, 41(3): 272-275,281.
[4]	何晨熙, 朱新影, 赵东强. 《2020国际共识：诊断性超声内镜在慢性胰腺炎管理中的作用》解读[J]. 河北医科大学学报, 2020, 41(12): 1365-1368.
[5]	张培建, 刘孟东, 刘科霞, 王雅琪, 刘旭光. 生长抑素预防ERCP术后高淀粉酶血症及胰腺炎疗效的研究[J]. 河北医科大学学报, 2020, 41(11): 1276-1280.
[6]	米俊, 华鹏, 崔翔, 周荣赛. 免疫增强型肠内营养方案联合微创腹腔引流在重症急性胰腺炎中的临床应用[J]. 河北医科大学学报, 2020, 41(10): 1136-1139,1144.
[7]	纪晨光，赵东强. 《2018国际指南：慢性胰腺炎截面影像学诊断和严重程度评分》解读[J]. 河北医科大学学报, 2019, 40(5): 501-503.
[8]	聂立敏，段〓洁，赵〓瑞，刘艳霞，方艳伟*. 不同冲封管方式对胰腺炎患者留置鼻肠管通畅性的比较研究[J]. 河北医科大学学报, 2019, 40(5): 603-606.
[9]	李赛莲，许保，陈正义，黄晓曦，王齐全. 艾普拉唑联合生长抑素治疗重症急性胰腺炎的效果及安全性分析[J]. 河北医科大学学报, 2019, 40(11): 1261-1264.
[10]	高贺军1，晁志涛1，蔺正印1，郭怀斌2*. 腹腔镜下经胆囊管汇入部微切开胆道探查的临床应用#br#[J]. 河北医科大学学报, 2019, 40(1): 98-101.
[11]	王春城1，唐宇菲2，暴〓雷1，温军业1，曹月敏1*，张万星1. 孢曲松钠致胆囊结石1 027例文献分析#br#[J]. 河北医科大学学报, 2018, 38(3): 272-275.
[12]	王〓威，石〓鑫，陈〓虎，苗伏龙，秦琦瑜，陈进军. 熊去氧胆酸对家兔保胆取石术后胆囊胆汁成分和胆囊组织中VIP和Calponin表达的影响[J]. 河北医科大学学报, 2016, 37(9): 1014-1017.
[13]	刘云峰 1,高咏梅 2,杨婕琳 2,马琴琴 3,韩树池 1,王俊利 1. 杂合式血液净化序贯治疗重症急性胰腺炎的疗效观察[J]. 河北医科大学学报, 2016, 37(8): 953-956.
[14]	高咏梅1，刘云峰2. 高容量血液滤过联合前列地尔对重症急性胰腺炎血管活性物质的影响及临床疗效[J]. 河北医科大学学报, 2016, 37(6): 697-700.
[15]	李新江，方艳伟，魏浩飞，孙海滨，王川，赵建辉. 细胞间黏附分子1高表达与大鼠SAP早期急性肺损伤的关系[J]. 河北医科大学学报, 2016, 37(4): 392-396.

急性胆源性胰腺炎发病危险因素分析

Analysis of risk factors of acute biliary pancreatitis

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价