摘要
目的探讨老年患者内镜逆行胰胆管造影术(ERCP)后出现高淀粉酶血症的影响因素。方法回顾性分析2020年9月—2021年11月同济大学附属上海市第四人民医院经ERCP治疗的54例老年患者的临床资料。根据术后24h血淀粉酶水平,将受试者分为高淀粉酶血症组(n=15)和对照组(n=39)。采集患者的性别、年龄、体质量指数、术前白细胞、术前中性粒细胞、术前C反应蛋白(CRP)、术前肝功能和术前/后24h血淀粉酶;记录ERCP操作时间、有无鼻胆管引流和术后是否出现高淀粉酶血症。分析ERCP术后出现高淀粉酶血症的危险因素。结果高淀粉酶血症组术前白细胞、术前中性粒细胞和术前CRP均高于对照组;ERCP操作时间长于对照组(均P<0.05)。进一步Logistic回归分析显示,术前白细胞升高(OR=5.405,P=0.024)和ERCP操作时间长(OR=1.631,P=0.003)是老年患者ERCP术后出现高淀粉酶血症的独立危险因素。结论老年患者控制术前白细胞数和ERCP操作时间,可减少ERCP术后出现高淀粉酶血症。
Objective To investigate the influencing factors of hyperamylasemia after endoscopic retrograde cholangiopancreatography(ERCP)in elderly patients. Methods The clinical data of54 elderly patients treated with ERCP in Shanghai Fourth People’s Hospital Affiliated to Tongji University from September2020 to November2021 were retrospectively analyzed. According to the level of blood amylase24 hours after operation,these patients were divided into hyperamylasemia group(n= 15)and control group(n= 39). The patients’ gender,age,body mass index,preoperative white blood cells(WBC),preoperative neutrophils,preoperative C-reactive protein(CRP),preoperative liver function and preoperative/postoperative24-h blood amylase,ERCP operation time and with or without nasobiliary drainag were collected. The risk factors of hyperamylasemia after ERCP were analyzed. Results The preoperative WBC,preoperative neutrophils and preoperative CRP of the hyperamylasemia group were higher than those of the control group and ERCP operation time was longer than that of the control group(all P< 0.05). Further Logistic regression analysis showed that preoperative WBC elevation(OR= 5.405,P= 0.024)and long ERCP operation time(OR= 1.631,P= 0.003)were independent risk factors for hyperamylasemia in elderly patients after ERCP. Conclusion The control of preoperative WBC count and ERCP operation time in elderly patients may reduce the occurrence of hyperamylasemia after ERCP.
作者
缪冉
朱娜
刘志全
姚文衍
李鲲鹏
蔡澄
薛春华
王道恒
宋旭炜
戚大川
Miao Ran;Zhu Na;Liu Zhiquan;Yao Wenyan;Li Kunpeng;Cai Cheng;Xue Chunhua;Wang Daoheng;Song Xuwei;Qi Dachuan(Department of Hepatobiliary and Pancreatic Surgery,Shanghai Fourth People's Hospital Affiliated to Tongji University,Shanghai,200434,P.R.China)
出处
《老年医学与保健》
CAS
2022年第1期20-23,共4页
Geriatrics & Health Care
基金
同济大学研究生教育研究与改革医学专项(1500106028/030)
虹口区卫生健康委员会临床重点扶持专科建设计划(HKZK2020A09)。
关键词
老年
高淀粉酶血症
内镜逆行胰胆管造影术
影响因素
elderly
hyperamylasemia
endoscopic retrograde cholangiopancreatography(ERCP)
influencing factor
