重症急性胰腺炎并发胰性脑病早期危险因素分析  

Analysis of early risk factors of the pancreatic encephalopathy in patients with severe acute pancreatitis

作　　者：伏添 栾正刚[2] 张谞丰[3] FU Tian;LUAN Zheng-gang;ZHANG Xu-feng(Department of Intensive Care Unit,Shaanxi Hanzhong 3201 Hospital,Hanzhong 723000,Shaanxi,China;Department of Intensive Care Unit,The First Affiliated Hospital of China Medical University,Shenyang 110001,Liaoning,China;Department of Hepatological Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

机构地区：[1]三二○一医院重症医学科,汉中723000 [2]中国医科大学附属第一医院重症医学科,沈阳110001 [3]西安交通大学第一附属医院肝胆外科,西安710061

出　　处：《东南国防医药》2021年第3期257-261,共5页Military Medical Journal of Southeast China

基　　金：辽宁省自然基金资助计划(2019-MS-09);西安交通大学第一附属医院临床研究重点项目(XJTU1AF-CRF-2017-004)。

摘　　要：目的重症急性胰腺炎(SAP)并发胰性脑病的临床研究资料较少。文章旨在从SAP患者临床常见的检验指标及评分系统中筛选胰性脑病的早期危险因素,以期早期预警并提前干预。方法回顾性分析2014年1月至2020年5月在陕西汉中3201医院ICU住院时间超过96 h且符合纳入标准的115例SAP患者临床资料,以发生胰性脑病作为预后观察指标,评价临床常见的检验指标及评分系统是否为SAP患者并发胰性脑病的早期危险因素。结果胰性脑病的单因素Logistic回归分析结果显示,影响因素有酗酒史、疾病种类、CTSI评分、EPIC评分、GCS评分(P<0.05)。进一步行多因素Logistic回归分析显示,酗酒史(OR=5.329,95%CI:1.697~16.729,P=0.004)、EPIC评分(OR=1.963,95%CI:1.319~2.923,P=0.001)为SAP患者并发胰性脑病的早期危险因素。结论在临床救治过程中,需警惕存在酗酒史、入院24 h EPIC评分明显升高的SAP患者并发胰性脑病。Objective There are limited clinical research data on pancreatic encephalopathy(PE)with concurrent severe acute pancreatitis(SAP).This study aimed to screen the early risk factors for PE from the clinically common test indexes and scoring systems of SAP patients,so as to provide early warning and early intervention.Methods The clinical data from 115 SAP patients who were admitted at the ICU of Shaanxi Hanzhong 3201 Hospital for over 96 h between January 2014 and May 2020 and conformed to the inclusion criteria were retrospectively analyzed.The PE incidence was used as the prognosis observational index to evaluate whether the clinically common test indexes and scoring systems were the primary risk factors for PE in SAP patients.Results The univariate Logistic regression analysis results of PE suggested that,the influencing factors were history of alcoholism,disease type,CT score,EPIC score and GCS score(P<0.05).Further multivariate Logistic regression analysis indicated that,the history of alcoholism(OR=5.329,95%CI:1.697-16.729,P=0.004)and EPIC score(OR=1.963,95%CI:1.319-2.923,P=0.001)were the early risk factors for PE in SAP patients.Conclusion During the clinical treatment process,caution should be exercised for the risk of PE in SAP patients with a history of alcoholism and apparently elevated EPIC score within 24 h after admission.

关 键 词：重症急性胰腺炎 胰性脑病 早期危险因素 

分 类 号：R576[医药卫生—消化系统] R747.9[医药卫生—内科学]