急性胰腺炎保守治疗的临床疗效及预后影响因素分析  

Analysis of Factors Affecting Clinical Efficacy and Prognosis of Conservative Treatment in Patients With Acute Pancreatitis

作　　者：王伟[1] 张树仁 WANG Wei;ZHANG Shuren(Department of Gastroenterology,Baishan Central Hospital,Jilin Province,Baishan Jilin 134300,China)

机构地区：[1]吉林省白山市中心医院消化科,吉林白山134300

出　　处：《中国卫生标准管理》2025年第5期129-132,共4页China Health Standard Management

摘　　要：目的研究急性胰腺炎(acute pancreatitis,AP)保守治疗的临床疗效及预后影响因素分析。方法选取2021年9月—2023年9月吉林省白山市中心医院收治的72例AP患者,对其进行保守治疗,观察其治疗效果。对患者进行随访,根据随访28 d的生存情况分为存活组与死亡组,比较2组患者的基本资料及生化检测指标水平,分析AP预后的影响因素。结果保守治疗的总有效率为100%。随访结果显示死亡率为18.06%。存活组与死亡组在性别、病情严重程度、有无腹水、入院24 h尿量、有无组织感染或坏死及甘油三酯、淀粉酶、动脉血氧分压水平方面,差异无统计学意义(P>0.05);2组年龄、CT严重程度指数(CT severity index,CTSI)评分、Ranson评分、入院48 h急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、白蛋白、血尿素氮、血肌酐、动脉血pH值比较,差异均有统计学意义(P<0.05)。经多因素logistic回归分析显示,年龄(95%CI=1.005~1.653,P<0.05)、CTSI评分(95%CI=1.717~4.833,P<0.05)、Ranson评分(95%CI=2.288~11.686,P<0.05)、入院48 h APACHEⅡ评分(95%CI=1.166~3.461,P<0.05)、白蛋白(95%CI=0.502~0.998,P<0.05)、血尿素氮(95%CI=1.779~8.500,P<0.05)、血肌酐(95%CI=1.085~1.274,P<0.05)、动脉血pH值(95%CI=0.346~0.903,P<0.05)是患者预后的独立影响因素。结论保守治疗能有效缓解AP症状,但具有一定死亡风险,年龄、病情严重程度、生化指标水平可以判断预后,应综合考虑影响因素,及时对患者进行早期干预和治疗,以改善患者预后。Objective To investigate the clinical efficacy and prognosis factors of conservative treatment of acute pancreatitis(AP).Methods Seventy-two patients with AP in Baishan Central Hospital,Jilin Province from September 2021 to September 2023 were enrolled,and all patients received conservative treatment.The clinical outcomes were observed during the follow-up period,and patients were classified into survival group and death group according to the 28-day survival status. The basic data and biochemical parameters of patients in two groups were compared, and the risk factors affecting prognosis were analyzed. Results The total effective rate after conservative treatment was 100%. Follow-up results showed a mortality rate of 18.06%. There were no statistically significant differences between the survival group and the death group in terms of gender,disease severity, presence or absence of ascites, urine output within 24 hours of admission, presence of tissue infection or necrosis, triglyceride, amylase, and arterial blood oxygen partial pressure (P > 0.05). Age, CT severity index (CTSI) score, Ranson score, 48-hour acute physiology and chronic health evaluationⅡ (APACHEⅡ) score, albumin, blood urea nitrogen, serum creatinine, and arterial blood pH, the differences were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that age (95%CI =1.005- 1.653, P < 0.05), CTSI score (95%CI =1.717-4.833, P < 0.05), Ranson score (95%CI =2.288-11.686, P < 0.05), APACHEⅡ score at 48 h of admission (95%CI =1.166-3.461, P < 0.05), albumin (95%CI =0.502-0.998, P < 0.05), blood urea nitrogen (95%CI =1.779-8.500, P < 0.05), blood creatinine (95%CI =1.085- 1.274, P < 0.05), arterial blood pH value (95%CI =0.346-0.903, P < 0.05) were independent factors affecting patient prognosis. Conclusion Conservative treatment can effectively relieve the symptoms of AP, but it has a certain risk of death. Age, disease severity, and biochemical index levels can be used to predict prognosis and influencing factors

关 键 词：急性胰腺炎 保守治疗 疗效 预后 CT严重程度指数 RANSON评分 急性生理学和慢性健康状况评价Ⅱ 影响因素 

分 类 号：R576[医药卫生—消化系统]