重症急性胰腺炎继发胰腺感染患者的临床特征和影响因素分析  

Clinical characteristics and risk factors of secondary pancreatic infection in patients with severe acute pancreatitis

作　　者：陈炳勋[1] 李汉智[1] 王云龙[1] 李辰[1] 苟菲 CHEN Bing-xun;LI Han-zhi;WANG Yun-long;LI Chen;GOU Fei(First Affiliated Hospital of Nanyang Medical College , Nanyang , Henan 473058 , China)

机构地区：[1]南阳医学高等专科学校第一附属医院普通外科,河南南阳473058

出　　处：《中华医院感染学杂志》2019年第7期1069-1071,1075,共4页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关基金资助项目(201503186)

摘　　要：目的研究分析在重症急性胰腺炎(SAP)患者中影响早期胰腺炎感染的危险因素。方法选取2015年1月-2017年12月医院收治的174例SAP患者,按照发病之后两周发生继发性胰腺感染的情况分为感染组94例以及非感染组80例,回顾性分析两组患者的性别、年龄、病因、入院时APACHEⅡ分数、导管应用、肠功能障碍、机械通气、低氧血症、胰腺坏死、尿素氮、血肌酐、血清白蛋白、总胆红素、AST、ALT、平均动脉压、血细胞比容、血糖、血钙、血淀粉酶等各项指标和胰腺感染的关系。结果多因素分析结果显示,低氧血症、肠功能障碍、胰腺坏死程度、血清白蛋白水平、血肌酐、尿素氮、入院血细胞比容为重症急性胰腺炎患者继发胰腺感染的危险因素(P<0.05)。结论在治疗重症急性胰腺炎患者过程中,要重视患者的病因、生化功能和临床表现等各项指标,异常可能导致继发性胰腺感染,应对相关症状采取及时的治疗和护理。OBJECTIVE The study analyzed the risk factors associated with early pancreatitis infection in patients with severe acute pancreatitis (SAP). METHODS A total of 174 patients with severe acute pancreatitis who were treated in our hospital from Jan. 2015 to Dec. 2017 were selected, and were divided into the infected group (94 cases) and uninfected group (80 cases) according to the occurrence of secondary pancreatic infection within two weeks after SAP attack. The relation between indexes such as gender, age, etiology, APACHE H score at admission, catheter use, intestinal dysfunction, mechanical ventilation, hypoxemia, pancreatic necrosis, urea nitrogen, serum creatinine, serum albumin, total bilirubin, AST, mean arterial pressure, blood cell volume, blood glucose, blood calcium, serum amylase and pancreatic infection of all patients with severe acute pancreatitis were analyzed retrospectively. RESULTS Multivariate analysis results showed that hypoxemia, intestinal dysfunction, degree of pancreatic necrosis, serum albumin level, blood creatinine, urea nitrogen, blood cell specific capacity at admission were risk factors for secondary pancreatic infection in patients with severe acute pancreatitis (P<0.05). CONCLUSION In the treatment of patients with severe acute pancreatitis, it is necessary to pay attention to the indicators of the patients etiology, biochemical function and clinical manifestations. Abnormalities may lead to secondary pancreatic infection, and timely treatment and care of related symptoms should be taken.

关 键 词：危险因素 继发性胰腺感染 重症急性胰腺炎 

分 类 号：R576[医药卫生—消化系统]