标题：内镜下逆行胰胆管造影术后引发急性胰腺炎的危险因素及护理对策

      作者：王凤稳，张星河    (山东省立第三医院肝胆内镜外科，山东 济南 250033)

      卷次： 2018年29卷18期

      【摘要】 目的 分析内镜下逆行胰胆管造影(ERCP)术后引起急性胰腺炎的危险因素，并探讨相关护理干预措施。方法 选取2016年12月至2017年12月在山东省立第三医院肝胆内镜外科行 ERCP检查或治疗的 336例胆胰疾病患者为研究对象，分析其临床及实验室检查资料，观察ERCP术后引发急性胰腺炎的发生率，分析相关危险因素并探讨相关护理措施。结果 336例患者中，共21例发生术后胰腺炎，发生率为6.25%；术后发生胰腺炎和未发生胰腺炎者患者存在胰腺炎或者胰腺占位史(38.1% vs 15.9%)、存在胰管显影或者导丝辅助插管(47.6% vs 16.2%)和存在插管困难(52.4% vs 18.4%)的比例比较，术后发生胰腺炎患者明显高于未发生胰腺炎患者，差异均有统计学意义(P<0.05)；多因素Logistic回归分析结果显示，胰腺炎或者胰腺占位史、存在胰管显影或者导丝辅助插管、存在插管困难是导致 ERCP术后急性胰腺炎的危险因素(P<0.05)。结论 急性胰腺炎是ERCP术后重要的并发症，胰腺炎或者胰腺占位史、存在胰管显影或者导丝辅助插管、存在插管困难是其危险因素，需采取积极的护理措施。
      【关键词】 胰腺炎；内镜下逆行胰胆管造影；危险因素；护理
      【中图分类号】 R657.5+1 【文献标识码】 A 【文章编号】 1003—6350（2018）18—2856—03

Risk factors of acute pancreatitis after endoscopic retrograde cholangiopancreatography and nursinginterventions.
WANG Feng-wen, ZHANG Xing-he. Department of Hepatobiliary Surgery, Shandong Provincial ThirdHospital, Ji'nan 250033, Shandong, CHINA
【Abstract】 Objective To analyze the risk factors of acute pancreatitis after endoscopic retrograde cholangio-pancreatography (ERCP) and explore the related nursing interventions. Methods A total of 336 cases of cholangiopan-creatopancreatography in Department of Hepatobiliary Surgery, Shandong Provincial Third Hospital from December2016 to December 2017 were selected as the research subjects. The clinical and laboratory data were analyzed, and theincidence of acute pancreatitis after ERCP was observed. Related risk factors were analyzed and related nursing mea-sures were discussed. Results Among the 336 patients, 21 cases had postoperative pancreatitis, and the incidence was6.25%. The proportion of pancreatitis or pancreatic space occupying, the proportion of pancreatic duct development orguided silk assisted intubation, and the proportion of intubation difficulty were 38.1%, 47.6%, and 52.4% in patientswith pancreatitis versus 15.9%, 16.2%, and 18.4% in the patients without pancreatitis (P<0.05). Logistic regression anal-ysis showed that the history of pancreatitis or pancreatic space occupying, the existence of pancreatic duct developmentor guided silk assisted intubation, and the difficulty of intubation were the risk factors for acute pancreatitis after ERCP(P<0.05). Conclusion Acute pancreatitis is an important complication after ERCP. The history of pancreatitis or pan-creatic space occupying, the existence of pancreatic duct development or guided silk assisted intubation, and the difficul-ty of intubation are the risk factors. It is necessary to take active nursing measures.
      【Key words】 Pancreatitis; Endoscopic retrograde cholangiopancreatography (ERCP); Risk factors; Nursing·护 理·doi:10.3969/j.issn.1003-6350.2018.18.043