重症急性胰腺炎患者腹腔感染的危险因素分析  

Risk factors for abdominal infections in patients with severe acute pancreatitis

作　　者：孙燕[1] 杨兴菊[2] 段红伟[3] 李念梅[4] 

机构地区：[1]莱芜市人民医院急诊科,山东莱芜271100 [2]莱芜市人民医院监护室,山东莱芜271100 [3]莱芜市人民医院护理部,山东莱芜271100 [4]莱芜市人民医院普外科,山东莱芜271100

出　　处：《中华医院感染学杂志》2014年第5期1217-1219,共3页Chinese Journal of Nosocomiology

基　　金：山东省中医药科学发展计划基金项目(20070951)

摘　　要：目的探讨分析重症急性胰腺炎(SAP)患者合并腹腔感染的危险因素及干预对策,以降低感染的发生率。方法回顾性分析2008年1月-2013年1月SAP合并腹腔感染65例患者的临床资料,并选择同期收治的126例未合并腹腔感染者,采用logistic逐步回归分析,分析其感染危险因素及干预对策。结果单因素分析显示,感染组患者入院时APACHEⅡ评分(13.1±3.6)分、未感染组(9.5±2.9)分,感染组患者血钙(1.8±0.3)mmol/L、未感染组(2.0±0.3)mmol/L等,SAP患者合并腹腔感染危险因素包括高龄(>50岁)、腹部CT显示坏死、肠功能障碍(>5d)、入院时APACHEⅡ评分、血钙、合并低氧血症、并发多器官功能障碍综合征(MODS)等,而多因素分析进一步表明,并发MODS的危险性最大(OR=3.582),其余依次为肠功能障碍(OR=3.273)、腹部CT显示坏死(OR=2.960)等。结论 SAP合并腹腔感染与多种因素关系密切,临床上应针对性的采取对应的干预措施,有效控制感染,提高患者的治疗有效性及安全性。OBJECTIVE To explore the risk factors for abdominal infections in patients with severe acute pancreatitis （SAP） and put forward intervention measures so as to reduce the incidence of infections. METHODS From Jan 2008 to Jan 2013. the clinical data of 65 SAP patients complicated with abdominal infections were retrospectively analyzed. meanwhile. 126 patients without abdominal infections were also recruited, then the logistic regression analysis was performed. the risk factors for the infections were analyzed, and the intervention measures were put forward. RESULTS The univariate analysis showed that the APACHE II score on the admission was （13. 1±3. 6） points in the infection group. （9. 5±2. 9） points in the non-infection group; the blood calcium level was 0. 8±0. 3） mmol/L in the infection group. （2. 0±0. 3）mmol/L in the non-infection group; the risk factors for the abdominal infections in the SAP patients included the advanced age （more than 50 years old）, abdominal CT showing necrosis. bowel dysfunction （more than 5 days）. APACHEII score on admission. blood calcium. complication of hypoxemia. and complication of multiple organ dysfunction syndrome （MODS）; further multivariate analysis indicated that the complication of MODS was the greatest risk （OR = 3. 582）. followed by bowel dysfunction （OR= 3.273） and abdominal CT showing necrosis （OR= 2.960）. CONCLUSION The complication of abdominal infections in the SAP patients is closely related to many factors; it is necessary for the hospital to take targeted intervention measures so as to effectively control the infections and ensure the effectiveness and safety of treatment.

关 键 词：重症急性胰腺炎 腹腔感染 危险因素 干预对策 

分 类 号：R181.32[医药卫生—流行病学]