目的 探讨放置胆管支架与儿童内镜逆行胰胆管造影(ERCP)术后胰腺炎(PEP)的关系。方法 基于美国国家住院患者样本(NIS)数据库中的儿童患者,使用复杂抽样资料的Logistic回归和多重填补方法进行评价,并根据性别进行亚组分析。结果 放置胆管支架的儿童患者,患PEP的风险较未放置胆管支架的高(OR: 1.44,95% CI: 1.05~1.99,P=0.0246)。亚组分析结果显示,男性儿童放置胆管支架者患PEP风险约为未放置者的1.9倍(OR: 1.89,95% CI: 1.08~3.31,P=0.0262);女性儿童患者未发现放置胆管支架与PEP患病相关联。结论 放置胆管支架与儿童ERCP术后发生PEP风险增加相关,因此对儿童放置胆管支架时,应采取预防措施、停止或更改手术方式等,以降低发生PEP的危险。
Abstract
Objective To explore the relationships between bile duct stent placement and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in children.Methods Based on pediatric patients in the National Inpatient Sample (NIS) database of the United States, logistic regression accounting was used for survey design while multiple imputation was adopted to study the relationships between biliary stent placement and PEP. Subgroup analysis was conducted according to gender.Results Children with biliary stent placement were at higher risk of PEP than those without (OR: 1.44, 95% CI: 1.05-1.99, P=0.0246). The results of subgroup analysis showed that boys with biliary stent placement were about 1.9 times as vulnerable to PEP as those without (OR: 1.89, 95% CI: 1.08-3.31, P=0.0262), but for female pediatric patients, bile duct stent placement was not found to be associated with PEP.Conclusions Bile duct stent placement is associated with an increased risk of PEP in children. Therefore, when placing bile duct stents in children, clinicians should take preventive measures, discontinue surgery or change surgical approaches to reduce the risk of PEP.
关键词
儿童 /
内镜逆行胰胆管造影术 /
胆管支架 /
胰腺炎 /
危险因素
Key words
children /
endoscopic retrograde cholangiopancreatography /
bile duct stent placement /
pancreatitis /
risk factors
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基金
上海市公共卫生体系建设三年行动计划(2020-2022年)学科带头人计划(GWV-10.2-XD05);上海市自然科学基金(19ZR1469800);国家自然科学基金(81803335);上海市卫生和计划生育委员会基金(201840074)
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