限制液体量会影响心脏病患者内镜逆行胰胆管造影术后胰腺炎吗？
Does restricting fluid volume impact post-ERCP pancreatitis in patient with heart disease?
机构信息
Department of Gastroenterology, Graduate School of Medicine, Juntendo University; Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Tokyo, Japan.
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
出版信息
Saudi J Gastroenterol. 2021 Nov-Dec;27(6):355-360. doi: 10.4103/sjg.sjg_693_20.
METHODS
Two hundred and forty seven of 480 patients with naïve papilla undergoing therapeutic ERCP between April 2013 and March 2018 were enrolled for the study. The following patient characteristics were investigated: age, sex, body mass index, previous diseases (heart disease, renal failure, cerebrovascular disorders, coexisting malignancy and pulmonary disease), history of PEP, common bile duct diameter, diverticula and volume of fluid infused 24 hours after the procedure. All ERCP cases had naïve papilla and had undergone treatment.
RESULTS
The incidence of PEP was 8.5%. Significant differences were observed in the volume of fluid infused between patients without and with a history of heart disease (1,380 vs. 1,755 mL). The mean volume of the infused fluid was significantly lower in the PEP than non-PEP group (1,483 vs. 1,688 mL, P = 0.02). Moreover, PEP incidence differed according to a fluid infusion cutoff of 1,000 mL (7 vs. 11 cases of PEP in those with ≦1,000 mL and >1,000 mL fluid volume, respectively, P < 0.001).
CONCLUSION
Restricted fluid volume was a newly identified risk factor for PEP, particularly in patients with heart and renal diseases as comorbidities.
方法
纳入 2013 年 4 月至 2018 年 3 月间接受治疗性 ERCP 的 480 例初发乳头患者中的 247 例进行研究。调查了以下患者特征：年龄、性别、体重指数、既往疾病（心脏病、肾衰竭、脑血管疾病、并存恶性肿瘤和肺部疾病）、PEP 史、胆总管直径、憩室和术后 24 小时内输注的液体量。所有 ERCP 病例均为初发乳头，且均接受了治疗。
结果
PEP 的发生率为 8.5%。有心脏病史和无心脏病史患者之间输注的液体量存在显著差异（1,380 比 1,755 mL）。PEP 组和非 PEP 组之间输注的液体平均量有显著差异（1,483 比 1,688 mL，P = 0.02）。此外，根据 1,000 mL 的液体输注截止值，PEP 的发生率不同（分别有 7 例和 11 例 PEP 发生于液体量≦1,000 mL 和>1,000 mL 的患者中，P < 0.001）。
结论
限制液体量是 PEP 的一个新的危险因素，尤其是在伴有心脏病和肾脏病等合并症的患者中。
Zotero 插件