重症急性胰腺炎并发胸腔积液的危险因素分析及护理策略  

Risk factors analysis of severe acute pancreatitis complicated with pleural effusionand the nursing strategy

作　　者：周丙梅[1] 王银娥[1] 徐亚运 王梅梅 王英[1] Zhou Bingmei;Wang Yine;Xu Yayun;Wang Meimei;Wang Ying(Department of emergency surgery,the first affiliated hospitalof Bengbu Medical College,Bengbu,Anhui,233004,China)

机构地区：[1]蚌埠医学院第一附属医院急诊外科,安徽蚌埠233004

出　　处：《齐齐哈尔医学院学报》2022年第22期2182-2185,共4页Journal of Qiqihar Medical University

基　　金：蚌埠医学院自然科学项目(2021byzd083)。

摘　　要：目的分析重症急性胰腺炎(SAP)患者并发胸腔积液(PE)的危险因素,制定科学合理的护理策略,以期早期有效控制危险因素,改善疾病预后。方法选择2019年1月—2021年8月本科收治的157例重症急性胰腺炎患者作为研究对象,根据有无胸腔积液分为PE组(65例)和非PE组(92例)两组。应用单因素分析比较两组患者的一般人口学资料、实验室检查数据和临床急危重病情评分有无差异,应用多因素Logistic回归分析SAP并发PE的危险因素。结果相关分析表明,积液量与APACHEⅡ评分(r=0.673,P<0.001)和SOFA评分(r=0.858,P<0.001)均呈正相关关系;单因素分析表明,两组患者在中性粒细胞数(NEU)、清蛋白(ALB)、钙离子(Ca)、纤维蛋白原(FIB)、空腹血糖(GLU)、C反应蛋白(CRP)、血脂肪酶(LIP)、APACHEⅡ评分和SOFA评分比较,差异有统计学意义(P<0.05);多因素Logistic回归分析表明,FIB、LIP和SOFA评分是SAP并发PE的独立危险因素(P<0.01)。结论FIB、LIP和SOFA评分是SAP并发PE的独立危险因素,对疾病早期诊断和干预具有指导意义。在临床护理工作中要及时关注胸腔积液发展风险较高的患者,便于早期实施监测和针对性护理。Objective To analyze the risk factors of patients with severe acute pancreatitis(SAP)complicated with pleural effusion(PE)and formulate scientific and reasonable nursing strategies,so as to effectively control the risk factors in early stage and improve the prognosis of the disease.Methods The 157 patients suffered with severe acute pancreatitis those were admitted to emergency surgery department from January 2019 to July 2021 were enrolled as study subjects,and they were divided into PE group and non-PE group according to the presence or absence of pleural effusion.There were 65 cases in the PE group and 92 cases in the non-PE group.Univariate analysis was used to compare the differences in general demographic data,laboratory examination data and clinical critical condition score between the two groups,and multivariate Logistic regression was used to analyze the risk factors of SAP complicated with PE.Results Correlation analysis showed that effusion volume was positively correlated with APACHEⅡscore(r=0.673,P<0.001)and SOFA score(r=0.858,P<0.001).Univariate analysis showed that there were significant differences in neutrophil count(NEU),albumin(ALB),calcium ion(Ca),fibrinogen(FIB),fasting blood glucose(GLU),C-reactive protein(CRP),lipase(LIP),APACHEⅡscore and SOFA score between the two groups(P<0.05).Multivariate Logistic regression analysis showed that FIB,LIP and SOFA scores were independent risk factors for SAP complicated with PE(P<0.01).Conclusions FIB,LIP and SOFA scores were independent risk factors for SAP complicated with PE,and have guiding significance for early diagnosis and intervention of disease.In clinical nursing work,patients with high risk of pleural effusion development should be timely paid attention,so as to facilitate the early implementation of monitoring and targeted nursing.

关 键 词：重症急性胰腺炎 胸腔积液 危险因素 护理策略 

分 类 号：R471[医药卫生—护理学]