东南大学学报(医学版)
東南大學學報(醫學版)
동남대학학보(의학판)
JOURNAL OF SOUTHEAST UNIVERSITY(MEDICAL SCIENCE EDITION)
2015年
3期
352-356
,共5页
贾一平%茅爱武%蒋霆辉%方世明%范红
賈一平%茅愛武%蔣霆輝%方世明%範紅
가일평%모애무%장정휘%방세명%범홍
梗阻性黄疸%胆道引流%感染%相关因素
梗阻性黃疸%膽道引流%感染%相關因素
경조성황달%담도인류%감염%상관인소
obstructive jaundice%biliary drainage%infection%related factors
目的:探讨经皮肝穿刺胆道引流( PTBD)术前或术后感染发生的主要危险因素。方法:收集首次行经皮肝穿刺胆道支架和(或)引流的梗阻性黄疸、伴术前或术后感染的187例患者临床资料,对可能影响术前感染发生的10个变量及术后的11个变量进行多因素非条件Logistic回归模型拟合,采用逐步回归法,引入变量的显著性水平为0.10,剔除变量的显著性水平为0.15(α入=0.10,α出=0.15)。结果:得到7个有意义的术前感染相关因素(性别、年龄、肝功能Child-Pugh评分、糖尿病史、内镜下逆行胰胆管造影术史、梗阻部位及梗阻时间)和5个有意义的术后感染相关因素(性别、梗阻时间、引流方式、血培养情况、白细胞情况)。结论:男性、年龄>60岁、肝功能Child-Pugh评分、糖尿病史、内镜下逆行胰胆管造影术史( ERCP )、梗阻部位及梗阻时间是术前感染的相关因素,男性、梗阻时间、引流方式、血培养情况、白细胞情况是术后感染的相关因素。
目的:探討經皮肝穿刺膽道引流( PTBD)術前或術後感染髮生的主要危險因素。方法:收集首次行經皮肝穿刺膽道支架和(或)引流的梗阻性黃疸、伴術前或術後感染的187例患者臨床資料,對可能影響術前感染髮生的10箇變量及術後的11箇變量進行多因素非條件Logistic迴歸模型擬閤,採用逐步迴歸法,引入變量的顯著性水平為0.10,剔除變量的顯著性水平為0.15(α入=0.10,α齣=0.15)。結果:得到7箇有意義的術前感染相關因素(性彆、年齡、肝功能Child-Pugh評分、糖尿病史、內鏡下逆行胰膽管造影術史、梗阻部位及梗阻時間)和5箇有意義的術後感染相關因素(性彆、梗阻時間、引流方式、血培養情況、白細胞情況)。結論:男性、年齡>60歲、肝功能Child-Pugh評分、糖尿病史、內鏡下逆行胰膽管造影術史( ERCP )、梗阻部位及梗阻時間是術前感染的相關因素,男性、梗阻時間、引流方式、血培養情況、白細胞情況是術後感染的相關因素。
목적:탐토경피간천자담도인류( PTBD)술전혹술후감염발생적주요위험인소。방법:수집수차행경피간천자담도지가화(혹)인류적경조성황달、반술전혹술후감염적187례환자림상자료,대가능영향술전감염발생적10개변량급술후적11개변량진행다인소비조건Logistic회귀모형의합,채용축보회귀법,인입변량적현저성수평위0.10,척제변량적현저성수평위0.15(α입=0.10,α출=0.15)。결과:득도7개유의의적술전감염상관인소(성별、년령、간공능Child-Pugh평분、당뇨병사、내경하역행이담관조영술사、경조부위급경조시간)화5개유의의적술후감염상관인소(성별、경조시간、인류방식、혈배양정황、백세포정황)。결론:남성、년령>60세、간공능Child-Pugh평분、당뇨병사、내경하역행이담관조영술사( ERCP )、경조부위급경조시간시술전감염적상관인소,남성、경조시간、인류방식、혈배양정황、백세포정황시술후감염적상관인소。
Objective: To investigate the risk factors for infection of percutaneous liver biopsy biliary drainage ( PTBD) preoperative and postoperative .Methods:The clinical data of 187 patients who were first received with percutaneous transhepatic cholangio-drainages and had occurred infection before or after operation were collected . Through stepwise regression method and multivariate unconditional Logistic regression to analyse the 10 variables that may affect the occurrence of preoperative infection and the 11 variables that may affect the occurrence of postoperative infection.The significance of introducing variable is 0.10 and the significance of eliminate variables is 0.15.Results:This study shows that there are 7 significant factors affecting preoperative infection ( gender, age, Child-Pugh score of liver function , history of diabetes , history of the endoscopic retrograde pancreatic imaging , obstruction position and duration of obstruction ) and 5 significant factors affecting postoperative infection ( gender , duration of obstruction, drainage way, blood culture, the WBC).Conclusion: Male,age>60 years old, Child-Pugh score , liver function , diabetes history , history of endoscopic retrograde pancreatic angiography and duration of obstruction are related factors of preoperative infection; male, obstruction time, drainage way, white blood cells, blood culture condition are related factors of postoperative infection .