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Objective:To study the risk factors of acute gallstone pancreatitis (AGP) caused by impaction of duodenal papilla stones based on ERCP findings to provide evidence on prevention of AGP caused by stone impaction.Methods:The data of 304 patients with duodenal papilla stone impaction who were treated by ERCP at the Integrated Chinese and Western Medicine Hospital of Tianjin University from January 2009 to December 2020 were analyzed retrospectively. There were 177 males and 127 females, with a median age of 65.0 years. These patients were divided into the AGP group ( n=174) and the non-AGP group ( n=130) according to whether they developed acute pancreatitis before hospitalization. The analysis was performed on perioperative data. Multivariate logistic regression analysis was used to detect risk factors of AGP in patients with duodenal papillary stone impaction. Results:Multivariate logistic analysis showed that acute cholangitis ( OR=2.114, 95% CI: 1.279-3.494, P<0.05) and impacted stones ≤5 mm ( OR=1.738, 95% CI: 1.064-2.840, P<0.05) were independent risk factors of duodenal papillary stone impaction complicated with AGP. No perforation and death related to ERCP treatment occurred in both groups. The symptom alleviating time of patients in the AGP versus the non-AGP groups was (2.67±1.19) versus (1.88±0.88) d respectively ( t=-6.321, P<0.001). Conclusion:Among patients with duodenal papilla impacted stones, acute cholangitis and impacted stones ≤5 mm were risk factors of developing AGP, and ERCP should be carried out as early as possible.
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Objective To investigate the levels of lipoprotein associated phospholipase A2(Lp-PLA2),D-dimer(D-D),antithrombin Ⅲ (AT Ⅲ) in acute cerebral infarction (ACI)patients,and to analyzed their correlation with ACI.Methods Sixty-nine patients with ACI(ACI group) and 40 individuals undergoing healthy physical examination(control group) were selected in this study.The levels of Lp-PLA2,D-D and ATⅢ were compared between the two groups and their positive rates were statistically analyzed.Then the correlation between Lp-PLA2,D-D and ATⅢ with ACI was analyzed.Results The levels of Lp-PLA2 and D-D in the ACI group were higher than those in the control group,while the ATⅢ level was lower than that in the control group(P<0.05).Their positive rates in the ACI group were higher than those in the control group (P<0.05).Lp-PLA2,D-D and ATⅢ were correlated with ACI occurrence and had mutual correlation (all P<0.05).Conclusion Lp-PLA2,D-D and AT Ⅲ participate in the occurrence process of ACI,and their detection can be applied to screen out ACI high-risk groups,and may guide early prevention and early diagnosis of ACI.
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Objective To evaluate the clinical value and efficacy of prophylactic pancreatic duct stenting for biliary-type stenosis of Oddi sphincter with difficulty cannulation.Methods The present study was a retrospective study of 63 patients with biliary-type stenosis of Oddi sphincter and difficult cannulation.The stent group consisted 30 patients who underwent prophylactic pancreatic duct stenting from February 2010 to February 2011 and the control group included 33 patients who underwent only ERCP without prophylactic pancreatic duct stenting from January 2009 to January 2010.The incidence of postoperative pancreatitis were compared between the two groups.Results The incidence of postoperative pancreatitis of the control group was significantly higher than that of the stent group (P ＜ 0.05).Conclusion For patients with definite diagnosis of biliary-type stenosis of Oddi sphincter and difficult cannulation,prophylactic pancreatic duct stent placement is safe and effective.
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Objective To explore the safety of enteral nutrition(EN)support in non-blood circulation disorders of elderly patients with intestinal obstruction.Methods A total of 40 patients (22 men and 18 women aged 62-84 years)with intestinal obstruction were enrolled in this study.Ileus tubes were rapidly placed in these patients with the assistance of endoscopy and X-ray.Afterwards patients were equally randomized into parenteral nutrition(PN)and EN(PN+EN)group and PN only group.The clinical outcomes and complications were recorded and compared.Results The average time for catheter placement was(24.83 4±7.95)minutes.Abdominal pain were relieved within 1-2 hours in26 pafienta(65.0%)and within 48 hours in 11 patients(27.5%).In the PN+EN group,EN was provided(25.25±8.17)hours after catheter placement,and most patients could tolerate EN.Laboratory findings were not significantly different at admission between two groups.The mean prealbumin leveh were below than normal level at admission but returned normal after one week,which were significantly different inside each group(P<0.05)but were not significantly different between these two groups.The triglyceride leveh were higher than the normal level at admission but returned normal after treatment;however,the difference between the two groups was not significant.The laboratories tests were also not significantly different between two groups one week after admission.Conclusion EN support is safe for elderly patients with intestinal obstruction after effective gastrointestinal decompression.