Huang-Fu Li, Qian Ying-Hong, Qian Ming-Jie
Endoscopy Center, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Gastroenterology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Ann Palliat Med. 2021 Jul;10(7):7794-7801. doi: 10.21037/apm-21-1373.
The treatment of choledocholithiasis by endoscopic retrograde cholangiopancreatography (ERCP) is a difficult endoscopic procedure involving a complicated surgical process. During and after ERCP, surgery-related complications may occur, and serious complications can threaten the life of the patient. This study aims to evaluate the correlation between the possible complications of ERCP treatment of choledocholithiasis and the quality of life of patients, and to provide a basis for formulating corresponding intervention measures.
Using the Gastrointestinal Quality of Life Index (GIQLI) and the MOS item short from health survey (SF-36), we conducted random telephone follow-ups of 194 patients admitted to The Second Affiliated Hospital of Soochow University who underwent ERCP for the treatment of choledocholithiasis from October 2017 to December 2020. The patients' complications symptoms and quality of life were recorded, and a comparative analysis was performed.
During the hospitalization of the included 194 patients, complications occurred in 38 cases (19.6%), including 18 cases (9.3%) of hyperamylase, 11 cases (5.7%) of acute pancreatitis, and 5 cases (2.6%) of cholecystitis. There were 4 cases (2.1%) of gastrointestinal bleeding. The SF-36 scores in the complication group were significantly lower than those in the non-complication group across various dimensions, including bodily pain (BP), general health (GH), vitality (VT), social functioning (SE), and mental health (MH). Furthermore, the GIQLI scores in the complication group were lower than those in the non-complication group across various dimensions, including symptoms, subjective symptoms, physical function status, social activity status, as well as mental and psychological status. Multiple regression analysis showed that dimensions such as PF, BP, and subjective symptoms were more likely to be affected by hyperamylaseemia, acute pancreatitis, and cholecystitis, and the difference was statistically significant (P<0.05).
Complications after ERCP result in a poor quality of life after discharge in choledocholithiasis patients, suggesting that nurses need to take effective measures to prevent and actively treat hyperamylase, acute pancreatitis, and acute pancreatitis during the hospitalization of holedocholithiasis patients after ERCP. Common complications, such as cholecystitis, promote the recovery of patients and reduce the impact of the disease on quality of life.
内镜逆行胰胆管造影术（ERCP）治疗胆总管结石是一项操作难度大且手术过程复杂的内镜手术。在ERCP术中及术后，可能会发生与手术相关的并发症，严重的并发症会威胁患者生命。本研究旨在评估ERCP治疗胆总管结石可能出现的并发症与患者生活质量之间的相关性，为制定相应的干预措施提供依据。
采用胃肠道生活质量指数（GIQLI）和健康调查简表（SF-36），对2017年10月至2020年12月在苏州大学附属第二医院接受ERCP治疗胆总管结石的194例患者进行随机电话随访。记录患者的并发症症状及生活质量，并进行对比分析。
纳入的194例患者住院期间，38例（19.6%）发生并发症，其中高淀粉酶血症18例（9.3%），急性胰腺炎11例（5.7%），胆囊炎5例（2.6%），消化道出血4例（2.1%）。并发症组在各个维度的SF-36评分均显著低于无并发症组，包括躯体疼痛（BP）、总体健康（GH）、活力（VT）、社会功能（SE）和心理健康（MH）。此外，并发症组在各个维度的GIQLI评分也低于无并发症组，包括症状、主观症状、身体功能状态、社会活动状态以及精神心理状态。多元回归分析显示，生理功能（PF）、躯体疼痛（BP）和主观症状等维度更容易受到高淀粉酶血症、急性胰腺炎和胆囊炎的影响，差异有统计学意义（P<0.05）。
ERCP术后并发症导致胆总管结石患者出院后生活质量较差，提示护士需要采取有效措施预防并积极治疗ERCP术后胆总管结石患者住院期间的高淀粉酶血症、急性胰腺炎和胆囊炎等常见并发症，促进患者康复，减轻疾病对生活质量的影响。
