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[合并感染的胆道梗阻患者的临床特征]

[Clinical characteristics of biliary obstruction patients with infections].

作者信息

Fang W J, Li X, Jiang X, Duan S S, Ding J, Zuo L J, Zhang X L, Zhang X L, Han S

机构信息

Department of Microbiology and Immunology, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China.

Department of Parasitology, Harbin Medical University, Harbin, Heilongjiang 150081, China.

出版信息

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2022 Apr 8;34(3):311-314. doi: 10.16250/j.32.1374.2021244.

Abstract

OBJECTIVE

To analyze the clinical characteristics of biliary obstruction patients with infections, so as to provide insights into the clinical diagnosis and therapy of this comorbidity.

METHODS

A total of 45 biliary obstruction patients with infections that were admitted to the Second Affiliated Hospital of Harbin Medical University from October 2012 to September 2019 were enrolled, and 45 patients with biliary obstruction alone at the hospital during the same study period were recruited as controls. Univariate analysis was performed to analyze the epidemiological characteristics, clinical manifestations, laboratory examination results and imaging manifestations related to infection, and the statistically significant univariate was used as an independent variable for multivariate logistic regression analysis.

RESULTS

Compared with biliary obstruction alone, males (91.11% vs. 46.67%; = 20.737, < 0.01) and rural areas (62.22% vs. 22.22%; = 14.757, < 0.01) showed a significantly higher proportion in biliary obstruction patients with infections. The major clinical symptoms involved in had jaundice (45 cases, 100%) and abdominal pain (40 cases, 88.89%) in -infected patients. Logistic regression analysis showed that males [odds ratio () = 10.717, 95% confidential interval (): (2.571, 44.662)] and drinking alcohol [ = 4.474, 95% : (1.019, 19.642)] were risk factors for biliary obstruction patients with infections, while living in city [ = 0.128, 95% : (0.038, 0.435)] was a protective factor. Additionally, in biliary obstruction patients with infections, lower total bilirubin ( = -2.566, <0.05) and direct bilirubin ( = -3.454, <0.05), higher indirect bilirubin ( = -3.821, < 0.05), thickening of the bile duct wall and dilatation of the intrahepatic bile duct were detected.

CONCLUSIONS

A comprehensive diagnosis requires to be made based on clinical symptoms, laboratory and imaging examinations, in order to improve the diagnosis of biliary obstruction patients with infections.

摘要

目的

分析合并感染的胆道梗阻患者的临床特征,为该合并症的临床诊断和治疗提供依据。

方法

选取2012年10月至2019年9月在哈尔滨医科大学附属第二医院收治的45例合并感染的胆道梗阻患者,并选取同期在该院单纯胆道梗阻患者45例作为对照。进行单因素分析以分析与感染相关的流行病学特征、临床表现、实验室检查结果及影像学表现,并将有统计学意义的单因素作为自变量进行多因素logistic回归分析。

结果

与单纯胆道梗阻相比,合并感染的胆道梗阻患者中男性比例(91.11%对46.67%;χ² = 20.737,P < 0.01)及农村地区患者比例(62.22%对22.22%;χ² = 14.757,P < 0.01)显著更高。合并感染患者的主要临床症状有黄疸(45例,100%)和腹痛(40例,88.89%)。logistic回归分析显示,男性[比值比(OR) = 10.717,95%置信区间(CI):(2.571,44.662)]及饮酒[OR = 4.474,95%CI:(1.019,19.642)]是合并感染的胆道梗阻患者的危险因素,而居住在城市[OR = 0.128,95%CI:(0.038,0.435)]是保护因素。此外,合并感染的胆道梗阻患者总胆红素(β = -2.566,P < 0.05)及直接胆红素(β = -3.454,P < 0.05)较低,间接胆红素(β = -3.821,P < 0.05)较高,胆管壁增厚及肝内胆管扩张。

结论

需综合临床症状、实验室及影像学检查进行诊断,以提高合并感染的胆道梗阻患者的诊断水平。

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