血液净化联合不同时机的营养治疗对急性胰腺炎继发性感染临床疗效的影响及危险因素的分析  

Influence of Blood Purification Combined with Nutritional Therapy at Different Times on the Clinical Efficacy of Secondary Infection in Acute Pancreatitis and Analysis of Risk Factors

作　　者：李晓 董璠[1] 王静[1] LI Xiao;DONG Fan;WANG Jing(Department of Nephrology,First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,471000,China)

机构地区：[1]河南科技大学第一附属医院肾脏内科二病区,河南洛阳471000

出　　处：《中国血液流变学杂志》2024年第2期246-249,259,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨血液净化联合不同时机的营养治疗对急性胰腺炎(acute pancreatitis,AP)继发性感染的临床疗效及其影响因素。方法回顾性分析2021年1月—2023年7月在河南科技大学第一附属医院肾脏内科收治的80例AP继发性感染患者的临床资料,根据血液净化和营养治疗的开始时间,将患者分为四组。比较四组患者的一般资料、严重程度评分、感染相关指标、并发症发生率和病死率,并分析影响临床疗效的危险因素。结果治疗后,四组患者的严重程度评分、感染相关指标均较治疗前明显改善(P<0.05),且A组优于B组、C组和D组(P<0.05)。A组的并发症发生率和病死率均低于B组、C组和D组(P<0.05)。多因素Logistic回归分析显示,血液净化和营养治疗的开始时间、治疗后的严重程度评分和感染相关指标是影响临床疗效的独立危险因素(P<0.05)。结论血液净化联合不同时机的营养治疗能够改善AP继发性感染患者的临床疗效,且血液净化和营养治疗的开始时间、治疗后的严重程度评分和感染相关指标是影响临床疗效的重要危险因素,应予以重视。Objective To investigate the clinical effects of blood purification combined with different timing nutritional therapy on secondary infection in patients with acute pancreatitis(AP)and its influencing factors.Methods A retrospective analysis was conducted on the patients who were enrolled in the Department of Nephrology,First Affiliated Hospital of Henan University of Science and Technology between January 2021 and July 2023.Clinical data of 80 patients with AP secondary infection were classified into four groups based on the initiation time of blood purification and nutritional therapy.General data,severity score,infection-related indicators,complication rate and mortality of the four groups were compared,and the risk factors affecting clinical efficacy were analyzed.Results After treatment,severity scores and infection-related indexes of the four groups were significantly improved compared with those before treatment(P<0.05),and group A was better than groups B,C and D(P<0.05).The incidence of complications and mortality in group A were lower than those in groups B,C and D(P<0.05).Multivariate Logistic regression analysis showed that start time of blood purification and nutrition treatment,severity score after treatment and infection-related indicators were independent risk factors affecting clinical efficacy(P<0.05).Conclusion Blood purification combined with nutrition therapy at different times can improve clinical efficacy of patients with AP secondary infection.Start time of blood purification and nutritional therapy,severity score after treatment and infection-related indicators are important risk factors affecting clinical efficacy,and should be paid attention to.

关 键 词：血液净化 营养治疗 急性胰腺炎 继发性感染 临床疗效 危险因素 

分 类 号：R459.5[医药卫生—治疗学] R576[医药卫生—临床医学]