High-risk Factors Of Clinical Studies For Biliary Tract Infections Caused By Biliary Obstruction

Objective: To study the clinical factors associated with biliary tract infections cau sed by biliary obstruction,provide guidance for diagnosis,treatment and prevention.Methods: Collect 114 cases of biliary obstruction patients who received PTCD/PT GD treatment in Zunyi medical college from Sep.2015 to Oct.2016 as objects of observation.including 65 male and 49 female,aged from 35 to 91,average aged 65.57 years.Average time of obstruction is 24.51 days before surgery.All cases were adopted ultrasound,CT,MRI,and imaging examination,and were adopted liver function,blood routine,tumor antigen markers and etx examination,in the meantime,bacterial culture was donw for bile which is taken in surgery.Diagnosis on whether there is biliary tract infection according to the symptoms,signs,bacterial culture and the result of imaging examination,laboratory examination.Ten kinds of related clinical data for biliary obstruction cases,including gender(male,female),age(?60,< 60 years old),cause of disease(tumor,calculus),time of obstruction(?10,< 10 days),obstruction position(high position,low position),obstruction degree(completely,partiality),biliary surgery history(yes,no),liver function Child-Pugh score(< 11,?11),preoperative alkaline phosphatase concentrations(<300U/L,300-600U/L,?600U/L),results of bile culture(yes,no)were collected.Analysis was done by SPSS 17.0 statistical software,as P<0.05 has stastistical significance.Results: 67 cases of biliary tract infections was caused by biliary obstruction in 114 cases of biliary obstruction,infection rate was 58.9%(67/114),isolated 98 strains Microorganism totally,the common Microorganism as per sequence is Escherichia coli 28.6%(28/98),Klebsiella pneumoniae 12.2%(12/98),Enterococcus faecalis 7.1%(7/98),Enterococcus faecium 5.1%(5/98),Enterobacter cloacae 5.1%(5/98).The single factor analysis related to biliary tract infection factors: gender(c2=0.023,P=0.394),age(c2=0.136,P=0.432),alkaline phosphatase concentration before surgery(c2=5.593, P=0.054),without statistical significance in these three factors;Obstruction etiology(c2=18.958,P=0.000),obstruction of time(c2=17.365,P=0.000),obstruction position(c2=4.634,P=0.026),degree of obstruction(c2=8.144,P=0.004),history of biliary tract surgery(c2=5.530,P= 0.015),liver function Child-Pugh score(c2=5.955,P=0.012),results of bile culture(c2=6.958,P=0.009)is related factors of biliary tract infections caused by biliary obstruction.There are statistically significant for errors.Among stone obstruction,short obstruction time,low position obstruction,Incompletely obstruction,historyof biliary tract surgery,liver function Child-Pugh score ?11,results of bile culture is high risk factors of biliary tract infections caused by biliary obstruction.According to multiple factors Logistic report,stone obstruction,history of biliary tract surgery,liver function Child-Pugh score ?11 and results of bile culture is independent risk factors.Conclusion: Biliary tract infections caused by biliary obstruction easily,among stone obstruction,short obstruction time,low position obstruction,incompletely obstruction,historyof biliary tract surgery,liver function Child-Pugh score ?11,results of bile culture is high risk factors of biliary tract infections.Stone obstruction,history of biliary tract surgery,liver function Child-Pugh high score and results of bile culture is independent risk factors.