急性胰腺炎继发胰周感染的危险因素分析  

Analysis of risk factors for peripancreatic infection secondary to acute pancreatitis

作　　者：周书毅 黄耿文[1] 申鼎成 宁彩虹 林嘉晏 曹昕彤 纪连栋[1] 魏伟[1] 陆晔斌[1] ZHOU Shuyi, HUANG Gengwen, SHEN Dingcheng, NING Caihong,LIN Jiayan, CAO Xintong, JI Liandong, WEI Wei, LU Yebin(Department of Pancreatobiliary Surgery, Xiangya Hospital, Central South University, Changsha 410008, China)

机构地区：[1]中南大学湘雅医院胰胆外科,湖南长沙410008

出　　处：《中国普通外科杂志》2018年第9期1148-1154,共7页China Journal of General Surgery

基　　金：湖南省技术创新引导计划资助项目(2017SK50101);中南大学湘雅医院管理研究基金资助项目(2016GL12);吴阶平医学基金会临床科研专项资助基金资助项目(320.6750.17518)

摘　　要：目的:探讨急性胰腺炎(AP)早期继发胰周感染的危险因素。方法:回顾性分析2010年1月—2016年10月间中南大学湘雅医院连续收治的、起病72 h内入院的826例AP患者资料,比较其中住院期间出现胰周感染与未出现胰周感染患者之间临床特点及入院24 h血化验结果,分析胰周感染的危险因素,并单独分析急性重症胰腺炎(SAP)继发胰周感染的危险因素。结果:826例AP患者中,发生胰周感染患者30例(3.6%)。单因素与多因素Logistic回归分析结果显示,持续器官功能衰竭(>48 h)(OR=21.143,P<0.001)、男性(OR=11.659,P=0.003)以及入院24 h内白蛋白降低(OR=0.872,P=0.006)是预测AP患者发生早期胰周感染的独立危险因素。住院期间,59例SAP患者发生胰周感染21例(35.6%),单因素与多因素Logistic回归分析结果显示,持续性器官功能衰竭(>1周)(OR=7.47,P=0.007)是SAP继发胰周感染的独立危险因素。结论:起病早期出现持续性器官功能衰竭,男性以及入院24 h内白蛋白减少是AP患者继发胰周感染的危险因素,且器官功能衰竭持续时间越长,发生胰周感染的风险越高。Objective： To investigate the risk factors for early peripancreatic infection secondary to acute pancreatitis （AP）. Methods： The clinical data of 826 consecutive AP patients admitted within 72 h after onset between January 2010 and October 2016 in Xiangya Hospital, Central South University were analyzed retrospectively. Of the patients, the clinical characteristics and results of blood tests within 24 h after admission were compared between cases who developed peripancreatic infection and those without peripancreatic infection during hospitalization to analyze the risk factors for peripancreatic infection, and further, the risk factors for peripancreatic infection in patients with severe acute pancreatitis （SAP） were analyzed separately.Results： Of the 826 AP patients, 30 cases （3.6%） developed peripancreatic infection. The results ofunivariate and multivariate Logistic analyses showed that the persistent organ failure for more than 48 h （OR=21.143, P〈0.001）, male sex （OR=11.659, P=0.003） and decrease of albumin （OR=0.872, P=0.006） within 24 h after admission were independent risk factors for developing peripancreatic infection. Of the 59 patients with SAP, 21 cases （35.6%） developed peripancreatic infection during their hospital stay. The results of univariate and multivariate Logistic analyses revealed that persistent organ failure for more than one week （OR=7.47, P=0.007） was the independent risk factor for developing the peripancreatic infection. Conclusion： Persistent organ failure in the early stage, male sex and the decrease of albumin within 24 h after admission are risk factors for developing peripancreatic infection in AP patients, and the risk of peripancreatic infection is increased with the prolongation of the duration of organ failure.

关 键 词：胰腺炎 胰腺炎 急性坏死性 感染 危险因素 

分 类 号：R657.5[医药卫生—外科学]