重症急性胰腺炎患者早期胰腺感染的危险因素分析

目的 分析重症急性胰腺炎(severe acute pancreatitis,SAP)患者早期胰腺感染的危险因素,为SAP早期胰腺感染防治提供依据.方法 选择2012年8月至2014年12月在我院收治的96例SAP患者的病历资料进行回顾性分析,其中合并胰腺感染45例作为观察组,未合并感染51例作为对照组.对两组患者的年龄、性别、就诊时间、APACHEⅡ评分、血淀粉酶(Amylase,AMS)、血钙(Ca2+)、糖尿病史、低氧血症、机械通气进行单因素变量分析,并将具有统计学差异的单因素进行Logistic多因素分析.结果 单因素分析显示,两组APACHEⅡ评分、AMS、Ca2+、糖尿病史、低氧血症、机械通气的差异有统计学意义(t/x2=7.118,3.590,8.149,3.697,3.079,1.391;P＜0.05),即上述指标为SAP患者早期胰腺感染发生的危险因素;多因素回归分析显示,APACHEⅡ评分、糖尿病史、低氧血症是SAP患者早期胰腺感染发生的独立危险因素.结论 SAP患者早期胰腺感染的发生与APACHE Ⅱ评分、糖尿病史、低氧血症等密切相关,医师应密切关注上述危险因素,进而避免或降低早期胰腺感染的发生.

Risk factors of early pancreatic infection in patients with severe acute pancreatitis

Objective To explore risk factors of early pancreatic infection in patients with severe acute pancreatitis (SAP).Methods Clinical data of 96 patients with SAP in our hospital from August 2012 to December 2014 was retrospectively analyzed,of whom 45 cases with early pancreatic infection as observation group,51 cases without early pancreatic infection as control group.Single factor such as age,gender,admission time,APACHE Ⅱ score,blood amylase (AMS),blood calcium (Ca2+),history of diabetes,hypoxemia,mechanical ventilation in two groups were variable analyzed,and were further analyzed by multi-factor Logistic analysis.Results Single factor analysis showed that there were statistically significant differences in APACHE Ⅱ score,AMS,Ca2+,history of diabetes,hypoxemia,mechanical ventilation between two groups (t/x2=7.118,3.590,8.149,3.697,3.079,1.391;P＜0.05),namely indexes mentioned above were risk factors of early pancreatic infection in patients with SAP.Multiple factors regression analysis showed that APACHE Ⅱ score,history of diabetes,hypoxemia were independent risk factors of early pancreatic infection in patients with SAP.Conclusion APACHE Ⅱ score,history of diabetes,hypoxemia are closely related to early pancreatic infection in patients with SAP;physician should pay close attention to risk factors mentioned above to avoid or reduce early pancreatic infection.