摘要
目的:探讨内镜下逆行胰胆管造影(ERCP)取石术后的胆道感染病原菌特征,并分析其危险因素。方法:选取2020年4月~2023年10月期间我院收治的256例胆总管结石患者。根据患者ERCP取石术后是否发生胆道感染将其分为纳入感染组(n=31)和未感染组(n=225)。分析两组ERCP取石术后胆道感染病原菌特征及胆道感染发生的危险因素。结果:256例胆总管结石患者中,胆道感染发生率为12.11%(31/256)。31例ERCP取石术后发生胆道感染患者共分离出39株病原菌,以革兰阴性菌为主,共26株,占比66.67%;其次为革兰阳性菌,共10株,占比25.64%;最后为真菌,共3株,占比7.69%。感染组年龄≥60岁比例、既往存在胆道手术史比例、结石数目≥2个比例、存在奥狄括约肌功能障碍比例、糖尿病比例、术后胆汁引流存在梗阻比例、手术时间、术前TBil水平均高于未感染组(P<0.05)。合并年龄≥60岁、既往存在胆道手术史、结石数目≥2个、手术时间长、糖尿病、术后胆汁引流存在梗阻是胆道感染发生的危险因素(P<0.05)。结论:胆总管结石患者ERCP取石术后发生胆道感染的病原菌以革兰阴性菌为主,合并年龄≥60岁、既往存在胆道手术史、结石数目≥2个、手术时间长、糖尿病、术后胆汁引流存在梗阻是患者ERCP取石术后发生胆道感染的危险因素。
Objective:To investigate the characteristics of pathogenic bacteria of biliary tract infection after endoscopic retrograde cholangiopancreatography(ERCP)lithotomy,and to analyze its risk factors.Methods:256 choledocholithiasis patients who were admitted in our hospital from April 2020 to October 2023 were selected,patients were divided into infection group(n=31)and non-infection group(n=225)according to whether biliary tract infection occurred after ERCP lithotomy.The characteristics of pathogenic bacteria of biliary tract infection after ERCP lithotomy between the two groups were analyzed,and the risk factors of biliary tract infection were analyzed.Results:Among 256 cholangiolithiasis patients,the incidence of biliary tract infection was 12.11%(31/256).A total of 39 strains of pathogenic bacteria were isolated from 31 patients with biliary tract infection after ERCP,26 strains were mainly gram-negative bacteria,accounting for 66.67%.Next was gram-positive bacteria,with 10 strains,accounting for 25.64%.Finally,there were 3 strains of fungi,accounting for 7.69%.The proportion of age≥60 years old,the proportion of previous history of biliary tract surgery,the proportion of stone number≥2,the proportion of sphincter of Oddi dysfunction,the proportion of diabetes,the proportion of obstruction of postoperative biliary drainage,the operation time and the preoperative TBil level in infection group were higher than those in non-infection group(P<0.05).Combined age≥60 years old,previous history of biliary tract surgery,stone number≥2,long operation time,diabetes,and obstruction of postoperative biliary drainage were risk factors for biliary tract infection(P<0.05).Conclusion:Gramnegative bacteria are the main pathogens of biliary tract infection in patients with choledocholithiasis after ERCP.Combined age≥60 years old,previous history of biliary tract surgery,stone number≥2,long operation time,diabetes,and obstruction of postoperative biliary drainage are risk factors for biliary tract infection after ERCP lithotomy.
作者
许萍
王兆辉
房晓文
高金轩
张广璐
XU Ping;WANG Zhao-hui;FANG Xiao-wen;GAO Jin-xuan;ZHANG Guang-lu(Department of Endoscopic Center,Shandong Provincial Third Hospital,Ji'nan,Shandong,250031,China)
出处
《现代生物医学进展》
2025年第3期474-480,共7页
Progress in Modern Biomedicine
关键词
胆总管结石
内镜下逆行胰胆管造影取石术
胆道感染
病原菌特征
危险因素
Choledocholithiasis
Endoscopic retrograde cholangiopancreatography lithotomy
Biliary tract infection
Characteristics of pathogenic bacteria
Risk factor
