Analysis Of Risk Factors For Hepatolithiasis Complicated With Hepatic Abscess

Objective:To explore the risk factors of intrahepatic bile duct stones complicated with hepatic abscess,and to provide evidence for the diagnosis and treatment of intrahepatic bile duct stones complicated with hepatic abscess.Methods:The data of 150 patients with intrahepatic bile duct stones admitted to the First Affiliated Hospital of Kunming Medical University from December 2015 to December 2018 werecollected for retrospective analysis.Patients with intrahepatic bile duct stones were divided into case group(with liver abscess)and control group(with no liver abscess)according to whether they had liver abscess.The relevant factors of the two groups were compared:gender,age,body mass index(BMI),temperature at admission,medical history,diabetes history,location of bile duct stones,history of biliary surgery,absolute neutrophil count and absolute lymphocyte count(LYM#),C-reactive protein,Serum albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(AKP),direct bilirubin(DBIL),serum creatinine,with or without anemia.SPSS 19.0 statistical software was used for analysis,and the risk factors with statistical significance of single factor analysis were screened out.Logistic regression analysis was further performed to determine the independent risk factors of intrahepatic bile duct stones complicated with liver abscessResults:A total of 150 patients with intrahepatic bile duct stones were collected in this group.There were 51 male patients and 99 female patients,with an average age of 53.5±10.5 years and 45 patients with liver abscess.The incidence rate was 30%.Univariate analysis showed that the differences in BMI(P<0.001),absolute lymphocyte(P<0.001),serum albumin(P=0.002),medical history(P=0.001)and AST(P=0.024)were statistically significant(P<0.05).Further multivariate logistic regression analysis of the above risk factors showed that the independent risk factors for intrahepatic bile duct stones complicated with hepatic abscess were:absolute lymphocyte value<1.1*10?9/L(P<0.001,OR=23.459,95%)Cl=8.529-64.576),AST?40 U/L(P=0.012,OR=3.946,95%Cl=1.355-11.487),medical history?21d(P=0.010,OR=4.028,95%CI=1.389-11.681).Conclusion:The absolute value of lymphocytes decreased,AST increased,and acute biliary infection was an independent risk factor for intrahepatic bile duct stones complicated with liver abscess.Abnormal nutritional status is a risk factor for intrahepatic bile duct stones with hepatic abscess formation.Therefore,for patients with intrahepatic bile duct stones with the above factors,attention should be paid to the presence of liver abscess before surgery to select the best treatment plan to improve the prognosis of patients.