International Medicine and Health Guidance News ›› 2022, Vol. 28 ›› Issue (17): 2377-2382.DOI: 10.3760/cma.j.issn.1007-1245.2022.17.002

• Literature Analysis • Previous Articles     Next Articles

Risk factors of biliary infection after PTCD for patients with malignant obstructive jaundice 

Wang Fengyan1, Hou Jian2, Zhang Daoqiang3, Gong Qi3, Liu Chuanjie3, Han Zhihao4   

  1. 1 Department of Gastroenterology, Weihai Central Hospital, Qingdao University, Weihai 264400, China; 2 CT-MR Center, People's Hospital of Jimo District, Qingdao 266200, China;  3 Central Laboratory, Weihai Central Hospital, Qingdao University, Weihai 264400, China;  4 Department of Imaging, Weihai Central Hospital, Qingdao University, Weihai 264400, China
  • Received:2022-05-09 Online:2022-09-01 Published:2022-10-11
  • Contact: Han Zhihao, Email: hzh20090701@163.com

恶性梗阻性黄疸患者PTCD术后发生胆系感染的危险因素

王凤燕1  侯健2  张道强3  宫琪3  刘传杰3  韩志浩4   

  1. 1青岛大学附属威海市中心医院消化科,威海 264400; 2青岛市即墨区人民医院CT-MR中心,青岛 266200; 3青岛大学附属威海市中心医院中心实验研究室,威海 264400; 4青岛大学附属威海市中心医院影像科,威海 264400
  • 通讯作者: 韩志浩,Email:hzh20090701@163.com

Abstract: Objective To systematically assess the risk factors of biliary infection after percutaneous transhepatic cholangio drainage (PTCD) for patients with malignant obstructive jaundice. Methods The PubMed, Embase, Cochrane, Web of Science, CBM, CNKI, Wan fang, and VIP databases were searched for literatures from their establishment to April 2022. According to the selection and exclusion criteria, the relevant data were screened and extracted. The literatures' quality was assessed using the Newcastle-Ottawa Scale (NOS), and meta-analysis was performed using the RevMan5.3 software. Results The 6 included literatures were all case-control studies, with 237 cases in the case group and 582 in the control group. The main risk factors of biliary infection after PTCD for malignant obstructive jaundice were biliary surgery history, grade C liver function before operation, extrabiliary drainage indwelling time >1 month, and the appearance of biliary restenosis. The combined OR values and 95%CI of the above factors were 4.42 (2.31-8.46), 11.62 (5.22-25.84), 8.39 (5.17-13.641), and 8.07 (1.86-34.98), respectively; the "age ≥60 years old" factor was not statistically significant; and the "location of biliary obstruction" factor was controversial. Conclusions Biliary surgery history, grade C liver function before operation, extrabiliary drainage indwelling time > 1 month, and the appearance of biliary restenosis are the main risk factors for postoperative biliary infection. The predictive value of age and location of biliary obstruction for postoperative biliary infection needs to be further explored. Healthcare workers should focus on these factors and take targeted precautions to reduce the incidence of postoperative biliary infection.

Key words:  , Malignant obstructive jaundice, PTCD, Postoperative biliary infection, Risk factors, Meta-analysis

摘要: 目的 系统评估恶性梗阻性黄疸患者经皮肝穿胆道引流术(PTCD)术后发生胆系感染的危险因素。方法 检索建库至2022年4月期间PubMed、Embase、Cochrane、Web of Science、CBM、CNKI、万方、维普数据库,根据纳入、排除标准,对有关资料进行筛选和提取。利用纽卡斯尔-渥太华量表(NOS)对文献质量进行评估,利用RevMan5.3软件对其进行meta分析。结果 纳入的6篇文献均为病例对照研究,病例组237例,对照组582例。恶性梗阻性黄疸患者PTCD术后发生胆系感染的主要危险因素为既往胆道手术史、术前肝功能C级、胆道外引流留置>1个月、胆道再狭窄,对应OR值及95%可信区间分别为4.42(2.31~8.46)、11.62(5.22~25.84)、8.39(5.17~13.641)、8.07(1.86~34.98),“年龄≥60岁”因素无统计学意义,“胆道梗阻位置”因素存在争议。结论 既往胆道手术史、术前肝功能C级、胆道外引流留置>1个月、胆道再狭窄是术后发生胆系感染的主要危险因素;年龄因素和胆道梗阻位置因素对于术后发生胆系感染的预测价值有待进一步探讨。医护人员应对以上因素予以重点关注,采取针对性预防措施以减少术后胆系感染的发生。

关键词: 恶性梗阻性黄疸, PTCD, 术后胆系感染, 危险因素, meta分析