重症急性胰腺炎合并胰腺感染的易感因素研究  

The Predisposing Factors Study of Pancreatic Infection in Severe Acute Pancreatitis

作　　者：王家宝[1] 吕德超[1] 曹斌[1] 陈东[1] 曹荣格[1] 

机构地区：[1]安徽医科大学附属省立医院急诊外科,合肥230001

出　　处：《中国医药导刊》2011年第7期1125-1126,1128,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨与重症急性胰腺炎(SAP)患者胰腺感染有关的易感因素。方法:选取2008年5月～2010年7月间收治的102例重症急性胰腺炎患者,根据发病后胰腺是否继发感染,分为感染组和非感染组,先以单因素分析筛选有统计学意义的易感因素,再通过Logistic回归分析筛选与继发感染有关的易感因素,包括年龄、性别、病因、入院时APACHEⅡ评分、血淀粉酶、血钙、血糖、血红蛋白、血清白蛋白、肠功能障碍、低氧血症、胰腺坏死、并发MODS。结果:胰腺继发感染的总发生率为39.22%;两组患者在人院时APACHEⅡ评分、血ca、肠功能障碍≥5天、低氧血症、胰腺有坏死、并发MODS与胰腺感染有统计学意义(P<0.05或<0.01),重症胰腺炎患者继发胰腺感染相关因素的Logistic回归分析显示,血ca水平,肠功能障碍≥5天,胰腺坏死,合并MODS与继发胰腺感染明显相关。结论:在SAP发病过程中,血ca水平持续降低、肠功能障碍、胰腺明显坏死、并发MODS可能是导致胰腺发生感染的主要易感因素。Objective：To study the related factors for infection in patients with severe acute panereatitis.Methods：From May 2008 to Jul 2010.102 SAP patients were divided in two groups（infection group and non-infection group） according to whether secondary infection and analyzed predisposing factors.Single factor analysis was taken to screen the statistically significant predisposing factors.and then stepwise Logistic regression analysis was used to determine predisposing factors to secondary infection.The clinical and laboratory data in- eluding age, gender, pathogenesis. APACHE 11 score on admission, blood calcium, blood glucose, hemoglobin, serum albumin. enteric tract dysfunction≥5 day. hypoxemia, necrosis of pancreas. MODS.Results：The incidence rate in all patients secondary infection was 39.22%;APACHE 11 score on admission, blood calcium, enteric tract dysfunction≥5 day, hypoxemia, necrosis of pancreas, MODS were positively correlated with the incidence of pancreatic infection（P〈0.05 or P〈0.0l）and blood calcium was negatively correlated with the incidence of pancreatic infection （P〈0：01）,other factors were no significantly correlated with pancreatic infection（P〉0.05）. Conclusion：Blood calcium, enteric tract dysfunction≥5 day, necrosis of pancreas, MODS may be the important factors in the pancreatic infection.

关 键 词：重症胰腺炎 感染 易感因素 

分 类 号：R657.51[医药卫生—外科学]