妊娠期高脂血症性急性胰腺炎继发腹腔感染的影响因素分析  

Analysis of risk factors of abdominal infection secondary to hyperlipidemic acute pancreatitis during pregnancy

作　　者：王笑薇[1] 孙昀[2] 曹利军[2] 尹路[2] 鹿中华[2] Wang Xiaowei;Sun Yun;Cao Lijun;Yin Lu;Lu Zhonghua(Department of Intensive Gare unit, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China)

机构地区：[1]安徽医科大学第二附属医院2015级重症医学科,合肥230601 [2]安徽医科大学第二附属医院重症医学科,合肥230601

出　　处：《中国临床实用医学》2018年第3期14-19,共6页China Clinical Practical Medicine

基　　金：安徽省教育厅关于2017年度高校自然科学研究项目（KJ2017A183）

摘　　要：目的探讨妊娠期高脂血症性急性胰腺炎（HLAP）继发腹腔感染的影响因素。方法回顾性分析2009年9月至2016年12月安徽医科大学第一附属医院及第二附属医院重症医学科收治的99例妊娠期HLAP患者的临床资料，最终纳入40例HLAP患者，根据是否继发腹腔感染分为腹腔感染组（19例）和无腹腔感染组（21例）。详细记录患者血常规、生化（肝肾功能、电解质、血酯、血糖、乳酸、pH值等）、凝血功能等相关指标及入院后72 h生命体征最差值。采用SPSS 22.0软件对数据先行单因素分析，再对有统计意义的单因素进行logistic回归分析，探讨妊娠期HLAP继发腹腔感染的影响因素。结果两组患者的脉搏、呼吸、血红蛋白、甘油三酯、乳酸、血钙水平、低钙持续时间、血糖、血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、C-反应蛋白（CRP）、入院24 h内白蛋白水平比较，差异有统计学意义（P〈0.05）；进一步分析结果显示，患者入院后72 h呼吸、脉搏、甘油三酯、血糖、血钙及低钙持续时间指标为妊娠期HLAP患者继发腹腔感染的独立影响因素。结论积极降脂，加强对患者早期血钙、血糖水平的动态监测，并进行有效干预，实时评估患者的炎症状态及病情的严重程度，对减少妊娠期HLAP继发腹腔感染的发生有一定意义。Objective To investigate the risk factors of abdominal infection secondary to hyperlipi- demic acute pancreatitis during pregnancy. Methods Clinical data of 99 patients with hyperlipidemic acute pancreatitis during pregnancy were retrospectively analyzed by department of Intensive Care Unit, The Sec- ond Affiliated Hospital of Anhui Medical University in this study from September 2009 to December 2015, finally, clinical data of 40 patients matched condition. They were classified as abdominal infection group （ n = 19）and non-abdominal infection group（ n = 21 ）according to the outcome of infection. The characteristics of blood routine examination, biochemical test, coagulation function and the worse value for vital signs after 72 h in hospital were analyzed. Single factor analysis was performed on the data, and then the data, which had the statisitical significance,were performed on regression analysis for the factor of abdominal infection secondary to HLAP during pregnancy. Results Comparison of the pulse,breathe,hemoglobin,triglyceride, lactic acid, blood calcium,low calcium duration, blood glucose, prothrombin time, activated partial thrombo- platin time, C-reactive protein, albumin after 24 h in hospital between the two groups had significantly statis- tical significance（ P 〈 0. 05 ）. Further analysis results were indicated that the pulse, breathe, triglyceride, blood glucose, low calcium duration were the dependent of influential factors of abdominal infection sen- condary to HLAP. Conclusion Lower the blood lipid, monitoring the changes of serum calcium and glu- cose frequently and doing clinical intervention, assessing the severity dynamically should be helpful to re- duce the incidence of the abdominal infection secondary to HLAP during pregnancy.

关 键 词：高脂血症性急性胰腺炎 妊娠 高脂血症 急性胰腺炎 腹腔感染 统计学分析 

分 类 号：R714[医药卫生—妇产科学]