超声引导下经皮穿刺置管引流术治疗重症急性胰腺炎患者继发感染的危险因素  

Risk Factors of Secondary Infection in Patients with Severe Acute Pancreatitis Treated by Ultrasound-Guided Percutaneous Catheter Drainage

作　　者：孙向磊 李娅[2] 王燕[2] SUN Xianglei;LI Ya;WANG Yan(Department of Gastroenterology,Xiping County People's Hospital,Zhumadian Henan 463900)

机构地区：[1]西平县人民医院消化内科,河南驻马店463900 [2]郑州大学第一附属医院消化内科,河南郑州450052

出　　处：《医学临床研究》2025年第3期463-466,共4页Journal of Clinical Research

摘　　要：【目的】探讨超声引导下经皮穿刺置管引流术(PCD)治疗重症急性胰腺炎患者继发感染的危险因素。【方法】回顾性分析2021年1月至2024年1月两院收治的70例超声引导下PCD治疗的重症急性胰腺炎患者的临床资料,根据患者是否继发感染分为感染组(n=28)和未感染组(n=42)。收集所有患者临床相关资料,比较两组患者临床资料及相关实验室指标[白蛋白(ALB)、白细胞(WBC)计数、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、血小板计数(PLT)、尿素氮(BUN)],采用Logistic多因素回归分析重症急性胰腺炎患者继发感染的危险因素。【结果】感染组患者年龄≥60岁、入院时急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分>11分、机械通气时间≥6 d、低氧血症、多器官功能衰竭占比高于未感染组患者,WBC计数、PCT、hs-CRP高于未感染组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,WBC计数升高、hs-CRP升高、PCT升高、年龄≥60岁、入院时APACHEⅡ评分>11分、机械通气时间≥6 d、低氧血症、多器官功能衰竭是重症急性胰腺炎患者继发感染的危险因素(P<0.05)。【结论】超声引导下PCD治疗重症急性胰腺炎后继发感染与年龄、入院时APACHEⅡ评分、机械通气时间、低氧血症、多器官功能衰竭等因素有关,WBC计数、hs-CRP、PCT可作为重症急性胰腺炎患者继发感染的预测指标。【Objective】To investigate the risk factors of secondary infection in patients with severe acute pancreatitis treated by ultrasound-guided percutaneous catheter drainage(PCD).【Methods】The clinical data of 70 patients with severe acute pancreatitis treated with ultrasound-guided PCD from January 2021 to January 2024 were retrospectively analyzed,and the patients were divided into infected group(n=28)and uninfected group(n=42)according to whether they had secondary infection.Clinical data of all patients were collected,and clinical data and related laboratory indicators[albumin(ALB),white blood cell(WBC)count,hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),platelet count(PLT),blood urea nitrogen(BUN)]of the two groups were compared.Multivariate Logistic regression was used to analyze the risk factors of secondary infection in patients with severe acute pancreatitis.【Results】The age of the infected group was≥60 years old,the APACHEⅡscore at admission was>11 points,the mechanical ventilation time was≥6 days,the proportion of hypoxemia and multiple organ failure was higher than that of the uninfected group,and the WBC,PCT and hs-CRP were higher than that of the uninfected group,with statistical significance(P<0.05).Multivariate Logistic regression analysis showed that increased WBC count,increased hs-CRP,increased PCT,age≥60 years,APACHEⅡscore>11 points upon admission,mechanical ventilation duration≥6 days,hypoxemia and multiple organ failure were risk factors for secondary infection in patients with severe acute pancreatitis(P<0.05).【Conclusion】Secondary infection after treatment of severe acute pancreatitis with ultrasound-guided PCD is related to age,APACHEⅡscore at admission,mechanical ventilation time,hypoxemia,multiple organ failure and other factors.WBC count,hs-CRP and PCT can be used as predictors of secondary infection of severe acute pancreatitis.

关 键 词：胰腺炎 急性坏死性 穿刺术 导管 留置 引流术 

分 类 号：R576.1[医药卫生—消化系统]