梗阻性黄疸经皮肝穿刺胆道引流感染发生因素的探讨-东南大学学报医学版

梗阻性黄疸经皮肝穿刺胆道引流感染发生因素的探讨

单位：上海同仁医院介入诊疗中心, 上海 200050

分类号：R446

出版年·卷·期（页码）：2015·34·第三期（352-356）

摘要：

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.

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.

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