经内镜逆行胰胆管造影术老年患者术前胃潴留发生情况及其影响因素

doi:10.3969/j.issn.1671-7171.2025.07.030

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摘要【目的】探讨经内镜逆行胰胆管造影术(ERCP)老年患者术前胃潴留发生情况及其影响因素。【方法】拟行ERCP的174例老年患者,根据术前是否出现胃潴留分为潴留组和未潴留组,比较两组患者的基线资料以及药物服用情况,并采用多因素Logistic分析老年患者ERCP术前发生胃潴留的危险因素。【结果】174例患者共出现胃潴留56例。潴留组与未潴留组患者的性别、年龄、体重指数(BMI),是否合并肝硬化、高脂血症、高血压、酸中毒、低血钠及是否服用钙拮抗药的患者占比比较,差异均无统计学意义(P>0.05);潴留组合并糖尿病、胃溃疡、黄疸、低血钾的患者占比显著高于未潴留组(P<0.05),服用阿片类与生长抑素的患者占比显著高于未潴留组(P<0.05),服用谷氨酰胺的患者占比显著低于未潴留组(P<0.05)。经多因素Logistic分析证实,糖尿病、胃溃疡、黄疸、低血钾、阿片类药物、生长抑素药物是老年患者ERCP术前发生胃潴留的危险因素(P<0.05),服用谷氨酰胺则是老年患者ERCP术前发生胃潴留的独立保护因素(P<0.05)。【结论】影响老年患者在ERCP术前发生胃潴留的危险因素包括糖尿病、胃溃疡、术前黄疸、阿片类药物、生长抑素药物、低血钾症,服用谷氨酰胺为其保护因素,临床应在术前全面评估并及早干预。

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	张伟
	刘黎明
	张景涛

关键词 ：胰胆管造影术, 内窥镜逆行, 胃肌轻瘫, 老年人

Abstract：【Objective】To investigate the incidence and influencing factors of preoperative gastric retention in elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). 【Methods】A total of 174 elderly patients who planned to undergo ERCP were divided into retention group and non retention group according to whether gastric retention occurred before ERCP. The baseline data and drug use of the two groups were compared, and the risk factors of gastric retention in elderly patients before ERCP were analyzed by multivariate logistic. 【Results】There were 56 cases of gastric retention in 174 patients. The sex, age, body mass index (BMI), the proportion of patients with cirrhosis, hyperlipidemia, hypertension, acidosis, low blood sodium and taking calcium antagonists in retention group and non retention group had no statistical significance (P>0.05). The proportion of patients with retention combination and diabetes, gastric ulcer, jaundice, low blood potassium was significantly higher than that in non retention group, The proportion of patients taking opioids and somatostatin in retention group was significantly higher than that in non retention group, and the proportion of patients taking glutamine in retention group was significantly lower than that in non retention group (P<0.05). Multivariate logistic analysis confirmed that diabetes, gastric ulcer, jaundice, hypokalemia, opioids and somatostatin were risk factors for gastric retention in elderly patients before ERCP (P<0.05), and glutamine was an independent protective factor for gastric retention in elderly patients before ERCP (P<0.05). 【Conclusion】The risk factors of gastric retention in elderly patients before ERCP include diabetes, gastric ulcer, preoperative jaundice, taking opioids, taking somatostatin drugs, hypokalemia, and taking glutamine as its protective factor, which should be comprehensively evaluated before ERCP and early intervention.

Key words： Cholangiopancreatography, Endoscopic Retrograde Gastroparesis Aged

收稿日期: 2023-08-26

中图分类号:

R576.2

通讯作者: ^*E-mail:drzhangjingtao826@aliyun.com

引用本文:

张伟, 刘黎明, 张景涛. 经内镜逆行胰胆管造影术老年患者术前胃潴留发生情况及其影响因素[J]. 医学临床研究, 2025, 42(7): 1209-1212.
ZHANG Wei, LIU Liming, ZHANG Jingtao. Incidence and Influencing Factors of Preoperative Gastric Retention in Elderly Patients Undergoing Endoscopic Retrograde Cholangiopancreatography. JOURNAL OF CLINICAL RESEARCH, 2025, 42(7): 1209-1212.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.07.030 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I7/1209

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