| 摘要: |
| 目的 探讨超声引导下经皮经肝胆囊穿刺置管引流术(Percutaneous Transhepatic Gallbladder Drainage,PTGD)术后发生继发性脓肿(Secondary abscess,SA)的发生率及其危险因素。方法 回顾性分析南京医科大学附属无锡人民医院2010年1月至2017年12月间410例经超声引导下PTGD患者的临床资料,采用单因素和多因素Logistic回归分析相关危险因素。结果 12例(2.93%,12/410)患者PTGD术后出现SA,再次针对SA穿刺引流的成功率100%。对良性疾病梗阻、基础疾病、胆囊大小、腹水、凝血功能、血小板、糖化血红蛋白(HbA1C)、短期内引流管脱落/自行拔出等混杂因素进行校正后,Logistic回归分析表明短期内引流管脱落/自行拔出(OR=6.64,95%Cl：3.34～13.81,P=0.03)和HbA1C＞9.0%(OR=3.38,95%Cl：1.22～7.95,P=0.04)是引起术后SA的独立危险因素。结论 SA是超声引导下PTGD术后罕见的并发症,再次穿刺引流是治疗SA有效和安全的方法。临床可通过加强对穿刺引流管的保护和应用降血糖药物,降低PTGD术后SA的发生。 |
| 关键词: PTGD 继发性脓肿 Logistic回归分析 危险因素 |
| DOI： |
| 投稿时间：2018-08-06修订日期：2019-03-25 |
| 基金项目:无锡市医学青年人才(QNRC069) |
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| Risk Factors for Secondary Abscess after Ultrasound-guided Percutaneous Transhepatic Gallbladder Drainage |
| chen jun |
| () |
| Abstract: |
| Objective To investigate the incidence and risk factors of secondary abscess (SA) after ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD). Methods The clinical data of 410 patients underwent ultrasound-guided PTGD were analyzed retrospectively from January 2010 to December 2017 in Wuxi People"s Hospital Affiliated to Nanjing Medical University. Univariate and multivariate logistic regression analysis were used to evaluate the related risk factors. Results SA was found in 12 patients (2.93%, 12/410) underwent PTGD, and the success rate of second drainage due to SA was 100%. After the confounding factors such as benign disease obstruction, underlying disease, gallbladder size, ascites, coagulation, platelet, HbA1c, short-term drainage tube off/ pulled out were corrected, logistic regression analysis showed that short-term drainage tube off/ pulled out (OR=6.64, 95%Cl: 3.34～13.81, P =0.03) and HbA1C＞9.0% (OR=3.38, 95%Cl: 1.22～7.95, P=0.04) were the independent risk factors for postoperative SA. Conclusions SA is a rare complication of ultrasound-guided PTGD, and second drainage is an effective and safe method for the treatment of SA. The occurrence of SA after PTGD could be clinically reduced by strengthening the protection of drainage tube and applying hypoglycemic drugs. |
| Key words: percutaneous transhepatic gallbladder drainage secondary abscess Logistic regression analysis risk factors |
