重症急性胰腺炎后期局部并发症形成的临床多因素分析  

Multivariate clinical analysis of local complications in the later period of severe acute pancreatitis

作　　者：王寻 张浩[1] 阎雄[1] Wang Xun;Zhang Hao;Yan Xiong(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)

机构地区：[1]重庆医科大学附属第一医院肝胆外科,重庆400016

出　　处：《当代医学》2020年第26期36-40,共5页Contemporary Medicine

摘　　要：目的研究重症急性胰腺炎(severe acute pancreatitis,SAP)的临床特征,并分析重症急性胰腺炎后期发生并发症的危险因素。方法回顾性分析本院2015年1月至2019年6月收治的376例重症急性胰腺炎患者的临床资料,最终筛选出48例后期有局部并发症的重症急性胰腺炎(severe acute pancreatitis with local complications,LC-SAP)患者和86例后期无局部并发症的重症急性胰腺炎(severe acute pancreatitis with non-local complications,NLC-SAP)患者,分析LC-SAP组和NLC-SAP组患者后期发生并发症的危险因素。结果LC-SAP组的年龄、C反应蛋白、血尿素氮、改良CT严重指数(modified computed tomography severity index,MCTSI)和胃肠功能障碍时间(gastrointestinal dysfunction time,GIDT)均高于NLC-SAP组(P<0.05),而LC-SAP组的血钙和肾脏替代治疗率(renal replacement therapy rate,RRTR)低于NLC-SAP组(P<0.05)。在SAP中,血钙(OR=0.028,P=0.005,95%CI:0.002~0.348)是重症急性胰腺炎患者后期发生局部并发症的独立保护性因素,而较高的MCTSI(OR=3.991,P<0.001,95%CI:2.143~7.436)和胃肠功能障碍时间(OR=1.247,P=0.045,95%CI:1.045~1.547)是发生局部并发症的独立危险因素。结论低血钙,较高的MCTSI和胃肠功能障碍时间会增加SAP后期局部并发症的发生风险。Objective To study the clinical characteristics of severe acute pancreatitis(SAP),and to analyze the risk factors of complications in the later period of severe acute pancreatitis.Methods Retrospective analysis was performed to 376 cases of severe acute pancreatitis admitted to our hospital from January 2015 to June 2019.Finally,48 cases of severe acute pancreatitis with local complications at the later period were screened acute pancreatitis with local complications(LC-SAP)and 86 cases of severe acute pancreatitis with non-local complications(NLC-SAP).The basic information of these cases was collected,and the risk factors of late complications in the LC-SAP group and NLC-SAP group were analyzed.Results The age,C-reactive protein,blood urea nitrogen,modified computed tomography severity index(MCTSI)and gastrointestinal dysfunction time(GIDT)of patients in LC-SAP group were higher than those in NLC-SAP group(P<0.05),while the blood calcium and renal replacement therapy rate(RRTR)in the LC-SAP group were lower than those in the NLC-SAP group(P<0.05).The results show that in patients with SAP,serum calcium(OR=0.028,P=0.005,95%CI:0.002-0.348)was an independent protective factor for late complications in patients with severe acute pancreatitis,while a higher MCTSI(OR=3.991,P<0.001,95%CI:2.143-7.436)and time to gastrointestinal dysfunction(OR=1.247,P=0.045,95%CI:1.045-1.547)were independent risk factors for local complications.Conclusion Hypocalcemia,higher MCTSI,and longer gastrointestinal dysfunction time increase the risk of local complications in the later period of SAP.

关 键 词：局部并发症 重症急性胰腺炎 危险因素 

分 类 号：R576[医药卫生—消化系统]